Efficacy and safety of the cryoballoon‐based atrial fibrillation ablation in patients aged ≥80 years

Takashi Kanda; Masaharu Masuda; Naoya Kurata; Mitsutoshi Asai; Osamu Iida; Shin Okamoto; Takayuki Ishihara; Kiyonori Nanto; Takuya Tsujimura; Shota Okuno; Yasuhiro Matsuda; Yosuke Hata; Toshiaki Mano

doi:10.1111/jce.14166

September 11, 2019Journal of Cardiovascular Electrophysiology

Efficacy and safety of the cryoballoon‐based atrial fibrillation ablation in patients aged ≥80 years

View Full Paper

Ask AI

Bookmark

Share

Why the study?

Although the efficacy of cryoballoon ablation for atrial fibrillation is demonstrated, data on its efficacy in elderly patients are limited.

Does cryoballoon ablation provide similar 1-year AF-free survival and safety in patients aged ≥80 years compared to those <80 years with paroxysmal atrial fibrillation?

Structured PICO

Does cryoballoon ablation provide similar 1-year AF-free survival and safety in patients aged ≥80 years compared to those <80 years with paroxysmal atrial fibrillation?

P

Population

290 consecutive patients with paroxysmal atrial fibrillation (PAF) undergoing cryoballoon ablation, consisting of 49 patients aged ≥80 years and 241 patients aged <80 years.

I

Intervention

Cryoballoon ablation in patients aged ≥80 years

C

Comparator

Cryoballoon ablation in patients aged <80 years

O

Outcome

Atrial fibrillation (AF)-free survival rate at 1 year

Cryoballoon ablation for paroxysmal atrial fibrillation is feasible and safe in patients aged ≥80 years, demonstrating 1-year efficacy and complication rates comparable to those in younger patients.

Implication

Supports similar 1-year outcomes with cryoballoon ablation in octogenarians; hypothesis-generating and requires randomized confirmation.

Abstract

INTRODUCTION: The prevalence of atrial fibrillation (AF) increases with age. Although the efficacy of cryoballoon ablation (CB-A) in patients with AF has been demonstrated, data on the efficacy of this CB-A in elderly patients are limited. The aim of this study was to evaluate the 1-year efficacy and safety of CB-A in patients aged ≥80 years compared with those less than 80 years. METHODS: A total of 49 consecutive patients ≥80 years with paroxysmal AF (PAF) who underwent CB-A were compared with 241 patients aged <80 years. AF-free survival rate at 1 year and procedural data were compared between the groups. RESULTS: Median (25th, 75th quartile) age was 83 (82, 85) years in the older group and 68 (61, 73) years in the younger group. At 1-year follow-up, the success rate did not significantly differ between the groups. In Cox regression analysis, age ≥80 years was not significantly related to AF recurrence. Low-voltage areas were more frequently observed in the elderly group than the control group (39% vs 17%; P = .01). Fluoroscopy time and procedure time did not differ significantly. There was no significant difference in the occurrence rate of transient phrenic nerve palsy. No severe complications occurred in either group, including procedure-related deaths, atrioesophageal fistula, cardiac tamponade, and cerebrovascular embolic events. CONCLUSION: The results of our study showed that CB-A for PAF is a feasible and safe procedure even in elderly patients, with similar success and complication rates when compared with a younger population.