Arrhythmia Center, the First Affiliated Hospital of Ningbo University, Ningbo, China.
Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, Ningbo, Zhejiang Province, China.
Clin Cardiol. 2024 Jan;47(1):e24169. doi: 10.1002/clc.24169. Epub 2023 Oct 7.
Catheter ablation (CA) combined with left atrial appendage closure (LAAC) has emerged as a promising method to relieve symptoms while reducing the incidence of stroke in selected high-risk patients with atrial fibrillation (AF).
We aimed to investigate the clinical outcomes of combined CA and LAAC in elderly patients.
A total of 316 patients with symptomatic drug-refractory AF who underwent combined CA and LAAC between January 2016 and December 2020 were retrospectively included. Baseline characteristics, periprocedural complications, and clinical events during follow-up were recorded and compared between patients aged ≥ 75 years (n = 66) and <75 years (n = 250).
Pulmonary vein isolation and satisfactory LAAC were achieved in all patients. No patients experienced death or stroke/transient ischemic stroke periprocedurally. After a median follow-up of 12.2 (6.7-24.4) months and 11.9 (5.5-23.6) months, the rate of sinus rhythm maintenance was comparable between the two groups (≥75 years: 78.8% vs. <75 years: 80.8%; log-rank test, p = 0.674). The median follow-up periods for clinical outcomes were 27.9 (9.3-44.8) months and 25.2 (10.8-45.7) months, respectively. In patients aged ≥ 75 years, one suffered ischemic stroke, and one experienced major bleeding event. In patients aged < 75 years, four had ischemic stroke, and eight had major bleeding events. Two patients aged < 75 years died during follow-up, while none of the patients aged ≥ 75 years died.
Combining CA and LAAC was feasible, safe and effective in elderly patients with AF.
导管消融（CA）联合左心耳封堵（LAAC）已成为一种有前途的方法，可以在选定的高危心房颤动（AF）患者中缓解症状，同时降低中风的发生率。
我们旨在研究联合 CA 和 LAAC 在老年患者中的临床结果。
回顾性纳入了 2016 年 1 月至 2020 年 12 月期间接受联合 CA 和 LAAC 的 316 例有症状药物难治性 AF 患者。记录并比较了年龄≥75 岁（n=66）和<75 岁（n=250）患者的基线特征、围手术期并发症和随访期间的临床事件。
所有患者均实现了肺静脉隔离和满意的 LAAC。无患者在围手术期发生死亡或中风/短暂性脑缺血发作。中位随访 12.2（6.7-24.4）个月和 11.9（5.5-23.6）个月后，两组窦性心律维持率相当（≥75 岁：78.8% vs. <75 岁：80.8%；log-rank 检验，p=0.674）。临床结果的中位随访期分别为 27.9（9.3-44.8）个月和 25.2（10.8-45.7）个月。在年龄≥75 岁的患者中，1 例发生缺血性中风，1 例发生大出血事件。在年龄<75 岁的患者中，4 例发生缺血性中风，8 例发生大出血事件。2 例年龄<75 岁的患者在随访期间死亡，而年龄≥75 岁的患者无死亡。
在 AF 老年患者中，联合 CA 和 LAAC 是可行的、安全有效的。
