Ablation of XXXX in the elderly: results from the German Ablation Registry.

@entity1 @entity2917 @entity713 @entity299 @entity616
BACKGROUND: Catheter ablation (CA) is considered the treatment of choice for @entity1 with @entity2917 ( @entity2917 ). However, there is a tendency to avoid CA in the elderly because of a presumed increased risk of periprocedural atrioventricular (AV) @entity616 . OBJECTIVE: The purpose of this prospective registry was to assess age-related differences in the efficacy and safety of CA within a large population with @entity2917 . METHODS: A total of 3,234 consecutive @entity1 from 48 German trial centers who underwent CA of @entity2917 between March 2007 and May 2010 were enrolled in this study. The cohort was divided into three age groups: <50 years (group 1, n = 1,268 [39.2%]; median age = 40 [30.0-45.0] years, 74.1% @entity1 ), 50-75 years old (group 2, n = 1,707 [52.8%]; 63.0 [58.0-69.0] years, 63.0% @entity1 ), and > 75 years old (group 3, n = 259 [8.0%]; 79.0 [77.0-82.0] years, 50.6% @entity1 ). RESULTS: CA was performed with radiofrequency current (RFC) in 97.7% and cryoablation technology in 2.3% of all cases. No differences were observed among the three groups with regard to primary CA success rate (98.7% vs. 98.8 % vs. 98.5%; P = .92) and overall procedure duration (75.0 minutes [50.0-105.0]; P = .93). Hemodynamically stable pericardial effusion occurred in five group 2 (0.3%) and two group 3 (0.8%) @entity1 but in none of the group 1 (P <.05) @entity1 . Complete @entity713 requiring permanent pacemaker implantation occurred in two @entity1 in group 1 (0.2%) and six @entity1 in group 2 (0.4%) but none in group 3 (P = 0.41). During a median follow-up period of 511.5 days (396.0-771.0), @entity2917 recurrence occurred in 5.7% of all @entity1 . @entity1 >75 years (group 3) had a significantly longer hospital stay (3.0 days [2.0-5.0]) compared with group 1 (2.0 days [1.0-2.0]) or group 2 (2.0 days [1.0-3.0]) @entity1 (P <.0001). CONCLUSION: CA of @entity2917 is highly effective and safe and does not pose an increased risk for complete @entity713 in @entity1 over 75 years of age, despite a higher prevalence of structural @entity299 . Antiarrhythmic drug therapy is often ineffective in this age group; thus, CA for @entity2917 should be considered the preferred treatment even in elderly @entity1 .
