Background: The elderly population with atrial fibrillation (AF) is growing. There is limited evidence to suggest AF ablation as an effective treatment for the elderly. Objectives: This study aimed to investigate the temporal trends of first-time ablations in the elderly, the impact of age on major adverse cardiovascular events (MACE), and a composite endpoint of AF-related hospitalizations, repeat AF ablation, or use of antiarrhythmic drugs (AADs). Methods: Utilizing the Danish administrative registers, we incorporated individuals undergoing their first-time AF ablation from 2001 to 2020. Our cohort was divided into 3 age groups (<60, 60-74, and ≥75 years) and scrutinized across 4 consecutive 5-year intervals. Cox proportional-hazard multivariable analyses and cumulative incidences were used to evaluate the endpoints of 5-year MACE incidence and a 1-year composite endpoint of AF-related hospitalizations, repeat AF ablation, or use of antiarrhythmic drugs. Results: Elderly patients who underwent AF ablation increased significantly, from none in 2001 to 9% in 2020. The 5-year incidence of MACE in the elderly decreased from 61.9% (95% CI: 41.1%-82.7%) to 38.1% (95% CI: 31.9%-44.2%). The HR for age ≥75 years in the last time period was 1.52 (95% CI: 1.26-1.83). The 1-year composite outcome varied from 35.6% to 52.0%; age was not a consistent predictor. Conclusions: AF ablation use in the elderly has significantly increased over time. A notable decrease in MACE was evident across all age cohorts, with a particularly pronounced trend observed among the elderly population. Age was not an independent predictor of the composite endpoint.

Temporal Trends in Atrial Fibrillation Ablation in the Elderly

Fusco, Alessandra;Di Sabatino, Antonio;
2024-01-01

Abstract

Background: The elderly population with atrial fibrillation (AF) is growing. There is limited evidence to suggest AF ablation as an effective treatment for the elderly. Objectives: This study aimed to investigate the temporal trends of first-time ablations in the elderly, the impact of age on major adverse cardiovascular events (MACE), and a composite endpoint of AF-related hospitalizations, repeat AF ablation, or use of antiarrhythmic drugs (AADs). Methods: Utilizing the Danish administrative registers, we incorporated individuals undergoing their first-time AF ablation from 2001 to 2020. Our cohort was divided into 3 age groups (<60, 60-74, and ≥75 years) and scrutinized across 4 consecutive 5-year intervals. Cox proportional-hazard multivariable analyses and cumulative incidences were used to evaluate the endpoints of 5-year MACE incidence and a 1-year composite endpoint of AF-related hospitalizations, repeat AF ablation, or use of antiarrhythmic drugs. Results: Elderly patients who underwent AF ablation increased significantly, from none in 2001 to 9% in 2020. The 5-year incidence of MACE in the elderly decreased from 61.9% (95% CI: 41.1%-82.7%) to 38.1% (95% CI: 31.9%-44.2%). The HR for age ≥75 years in the last time period was 1.52 (95% CI: 1.26-1.83). The 1-year composite outcome varied from 35.6% to 52.0%; age was not a consistent predictor. Conclusions: AF ablation use in the elderly has significantly increased over time. A notable decrease in MACE was evident across all age cohorts, with a particularly pronounced trend observed among the elderly population. Age was not an independent predictor of the composite endpoint.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11571/1514518
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