Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
Heart Lung Circ. 2022 Jul;31(7):1006-1014. doi: 10.1016/j.hlc.2022.02.003. Epub 2022 Mar 15.
The prevalence and incidence of atrial fibrillation (AF) significantly increase with age. Catheter ablation is already recommended in the guidelines for this selected elderly population. This study aimed to explore the safety and effectiveness of AF catheter ablation in patients aged ≥80 years.
The data were based on the China-AF study. Patients with AF aged ≥80 years who received catheter ablation from August 2011 to December 2020 were selected. Catheter ablation included bilateral circumferential pulmonary vein antrum isolation with or without additional linear ablation. Patients were followed up every 6 months. Arrhythmia-free curves were generated using Kaplan-Meier analysis. Cox proportional hazards regression models were used to analyse the predictors for post-ablation recurrence.
A total of 270 patients were included in the study. Many patients had comorbidities: 73.7% had hypertension and 29.3% had diabetes mellitus. All patients achieved successful bilateral circumferential pulmonary vein antrum isolation. Total complications were noted in nine of 270 (3.3%) patients and nine of 286 (3.1%) ablation procedures. After the first ablation procedure, 74% of the whole cohort-78% patients with paroxysmal AF, and 66% patients with persistent AF - were free from atrial tachyarrhythmia at follow-up to 12 months. Patients with persistent AF, longer AF duration, and history of ischaemic stroke were more likely to have AF recurrence.
Patients with AF aged ≥80 years, although with many comorbidities, had low complication rates and favourable outcomes after catheter ablation. Catheter ablation was a safe and effective treatment to achieve sinus rhythm in the selected elderly patients.
心房颤动（房颤）的患病率和发病率随年龄增长显著增加。对于这一选定的老年人群，导管消融已被指南推荐。本研究旨在探讨≥80 岁患者行房颤导管消融的安全性和有效性。
该数据基于中国房颤研究。入选 2011 年 8 月至 2020 年 12 月行导管消融的年龄≥80 岁的房颤患者。导管消融包括双侧环肺静脉电隔离术，必要时加行线性消融。患者每 6 个月随访一次。采用 Kaplan-Meier 分析生成无心律失常曲线。采用 Cox 比例风险回归模型分析消融后复发的预测因素。
共纳入 270 例患者。许多患者合并有疾病：73.7%有高血压，29.3%有糖尿病。所有患者均成功实现双侧环肺静脉电隔离术。270 例患者中有 9 例（3.3%）和 286 例消融术中有 9 例（3.1%）出现总并发症。首次消融后，整个队列中有 74%的患者（阵发性房颤患者中 78%，持续性房颤患者中 66%）在 12 个月随访时无房性心动过速。持续性房颤、房颤持续时间较长和有缺血性脑卒中史的患者更可能发生房颤复发。
尽管合并多种疾病，但≥80 岁的房颤患者导管消融后的并发症发生率低，结局良好。导管消融是一种安全有效的治疗方法，可使选定的老年患者恢复窦性心律。
