Acute safety outcomes in younger and older patients with atrial fibrillation treated with catheter ablation.

PURPOSE

Catheter ablation for atrial fibrillation (AF) has been demonstrated to be safe and effective in subsets of patients with AF, but primarily in patients age <65. This study compared acute safety in patients age ≥65 vs. those <65 who have undergone catheter ablation for AF.

METHODS

A retrospective analysis of data from two Thomson Reuters MarketScan® research databases was performed on 5,947 patients who underwent catheter ablation for treatment of AF. Acute safety was measured as a composite endpoint of procedure-related adverse events coded ≤7 days post-procedure. A logistic regression model was fitted to this endpoint, using age (<65, ≥65) and relevant covariates. Peri-procedural mortality rates were examined among patients with inpatient ablation procedures, where death rates could be determined by discharge status.

RESULTS

The acute safety event rate was nearly identical between both groups. This finding persisted after adjusting for covariates in the logistic regression model (p = 0.6648). There were no peri-procedural mortalities among the 3,575 index ablation procedures performed in an inpatient setting.

CONCLUSION

Acute safety of catheter ablation for AF in patients ≥65 was consistent with that of younger patients. A prior history of hypertension and stroke was associated with a high risk for complications with AF ablation. These findings in a large, real world population may have implications for Medicare patients with AF.