University Heart Center Luebeck, Medical Clinic II (Department of Cardiology, Angiology and Intensive Care Medicine), University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Luebeck, Germany.
German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Luebeck, Germany.
Clin Res Cardiol. 2019 Feb;108(2):167-174. doi: 10.1007/s00392-018-1336-x. Epub 2018 Sep 5.
Catheter ablation (CA) is an established therapy for treatment of atrial fibrillation (AF). However, data about AF ablation using the cryoballoon (CB) in the elderly population are sparse. The aim of this single center retrospective study is to evaluate the safety and efficacy of CB ablation in patients ≥ 75 years compared to patients < 75 years.
Fifty-five consecutive patients aged ≥ 75 years (elderly group) were compared with 183 patients aged < 75 years (control group). All patients underwent pulmonary vein isolation (PVI) using the second-generation CB. The mean age in the elderly group was 78 ± 2.8 years and 60.8 ± 9.5 in the control group (p < 0.001). During 11.8 ± 5.4 months of follow-up, single procedure success rate for the elderly and the control group was 72.8 and 76%, respectively (p = 0.37). During redo ablation (n = 40), low-voltage areas in the LA were more frequently observed in elderly patients compared to the control group [1.0 (IQR 0-2.0) segments vs 2.0 (IQR 2.0-3.0) segments, respectively, p = 0.03]. The most common complication was transient phrenic nerve palsy, which only occurred in patients < 75 years (0 vs 7, p = 0.33). No severe complication such as procedure-related deaths, atrio-esophageal fistula, or cerebrovascular embolic events occurred.
Our data strengthen the value of CB ablation for the treatment of AF as an effective and safe procedure in elderly patients, with similar success and complication rates when compared with a younger population.
导管消融（CA）是治疗心房颤动（AF）的一种既定疗法。然而，关于老年人使用冷冻球囊（CB）进行 AF 消融的数据很少。本单中心回顾性研究的目的是评估与<75 岁患者相比，≥75 岁患者使用 CB 消融的安全性和有效性。
55 例连续≥75 岁的患者（老年组）与 183 例<75 岁的患者（对照组）进行比较。所有患者均采用第二代 CB 行肺静脉隔离（PVI）。老年组的平均年龄为 78±2.8 岁，对照组为 60.8±9.5 岁（p<0.001）。在 11.8±5.4 个月的随访期间，老年组和对照组的单次手术成功率分别为 72.8%和 76%（p=0.37）。在再次消融（n=40）中，与对照组相比，老年组左心房内低电压区更为常见[分别为 1.0（IQR 0-2.0）段和 2.0（IQR 2.0-3.0）段，p=0.03]。最常见的并发症是短暂性膈神经麻痹，仅发生在<75 岁的患者中（0 例与 7 例，p=0.33）。无严重并发症，如与手术相关的死亡、食道-心房瘘或脑血管栓塞事件发生。
我们的数据强化了 CB 消融治疗 AF 的价值，作为一种有效且安全的治疗方法，在老年患者中的成功率和并发症发生率与年轻患者相似。
