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

• DOI: 10.1111/jce.14166
• Publication Date: 2019-09-11T04:40:30Z
• Authors: 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
• Keywords: Aged, 80 and over; Male; Time Factors; Databases, Factual; Age Factors; Action Potentials; Middle Aged; Cryosurgery; Risk Assessment; 3. Good health; 03 medical and health sciences; Postoperative Complications; Treatment Outcome; 0302 clinical medicine; Heart Rate; Recurrence; Risk Factors; Atrial Fibrillation; Humans; Female; Aged; Retrospective Studies

AbstractIntroductionThe 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.MethodsA 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.ResultsMedian (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.ConclusionThe 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.