Introduction: Atrial Fibrillation (AF) ablation has made tremendous progress with respect to innovation, efficacy and safety. Contemporary large scale data on outcomes of catheter ablation for AF in the elderly is limited. The aim of our study was to examine outcomes in AF ablation in the elderly.
Methods: We identified AF (International Classification of Diseases,9th Edition Clinical Modification-ICD-9-CM 427.31) patients treated with catheter ablation(37.34) using the Nationwide Inpatient Sample (NIS). We investigated outcomes (mortality, complications and length of stay-LOS) in AF ablation. Multivariate analysis was done to assess the predictors of complications and in-hospital death.
Results: An estimated 55,547 AF ablations were performed from the 2011 to 2014 with 12,491(22.5%) of them being in patients >75 years of age. Majority of the procedures in patients >75 were in women (64.2%). Mortality rates in patients > 75 were higher than those in patients <75 years of age (0.59% vs 0.16%). Similarly the overall mortality and complication rate (5.65% vs. 5.4%), mean LOS (4 days vs 2.4 days) (Figure 1). In multivariate analysis age >75, female gender, increasing Charlson comorbidity score and CHADS2Vasc score >5 were significant predictors of mortality and complications (Figure 2).
Conclusion: The overall mortality, complication rates and LOS were higher in patients >75 years of age undergoing AF ablation. This suggests a need for future research into identifying the safety measures in AF ablations especially in the elderly and instituting appropriate interventions to improve overall AF ablation outcomes.