Division of Cardiology, Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, North Carolina 27710, USA.
Curr Opin Cardiol. 2011 Jan;26(1):25-9. doi: 10.1097/HCO.0b013e3283413978.
Atrial fibrillation is increasingly prevalent among older adults and is a major contributor to morbidity in this population due to associated strokes, heart failure, and quality of life impairment. Catheter ablation for atrial fibrillation is demonstrated to be superior to antiarrhythmic therapy for the control of symptomatic and medically refractory atrial fibrillation, but its safety and efficacy in the elderly are not well understood. Clinical trials to guide the optimal management strategy in this population are lacking.
Several nonrandomized clinical studies have recently addressed the issue of catheter ablation in the elderly and show favorable rates of success. Unfortunately, these studies are limited by the relatively small numbers of patients examined and often by their single-center and retrospective nature.
Before the results of these studies can be extrapolated, data from larger cohorts of elderly patients followed prospectively are desperately needed.
随着年龄的增长,心房颤动在老年人中的发病率越来越高,由于与中风、心力衰竭和生活质量下降相关,它是该人群发病的主要因素。导管消融治疗心房颤动的效果优于抗心律失常治疗,可有效控制有症状和药物难治性心房颤动,但导管消融治疗在老年人中的安全性和疗效尚不清楚。缺乏指导该人群最佳管理策略的临床试验。
最近几项非随机临床研究探讨了老年人心房颤动导管消融的问题,结果显示成功率较高。不幸的是,这些研究受到检查患者数量相对较少的限制,且往往具有单中心和回顾性的特点。
在这些研究结果可以外推之前,迫切需要前瞻性随访更大数量老年患者的数据。