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80岁及以上患者房颤消融的疗效与安全性。

Efficacy and safety of atrial fibrillation ablation in patients with aged 80 years or older.

作者信息

Yodogawa Kenji, Iwasaki Yu-Ki, Ito Nobuaki, Arai Toshiki, Hachisuka Masato, Fujimoto Yuhi, Hagiwara Kanako, Murata Hiroshige, Aizawa Yoshiyasu, Shimizu Wataru, Asai Kuniya

机构信息

Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.

出版信息

Heart Vessels. 2025 Mar;40(3):245-250. doi: 10.1007/s00380-024-02458-7. Epub 2024 Sep 11.

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia observed in the elderly. Its prevalence rises with age, particularly in individuals over 80 years old. While catheter ablation has emerged as a first line therapy for the patients with symptomatic AF, evidence on its application in elderly patients remains controversial. This study aimed to assess safety and efficacy outcomes of AF ablation in patients aged ≥ 80 years. Consecutive 1327 patients who underwent a first pulmonary vein isolation (PVI) for AF were retrospectively analyzed. Patients aged ≥ 80 years (elderly group, n = 107) were compared with patients aged < 80 years (younger group, n = 1220). At 1-year follow-up, there was no significant difference in AF free rate between the elderly and the younger group (72.0% vs. 73.9%, P = 0.786). Regarding major complications, the elderly patients had a greater incidence of periprocedural stroke (1.9% vs. 0.1%, P = 0.018). The rates of cardiac tamponade, phrenic palsy, and vascular complications were not significantly different between the 2 groups. PVI for AF is effective in patients aged ≥ 80 years with a similar success rate, but periprocedural stoke risk was higher compared to the younger population.

摘要

心房颤动(AF)是老年人中最常见的心律失常。其患病率随年龄增长而上升,尤其是在80岁以上的人群中。虽然导管消融已成为有症状AF患者的一线治疗方法,但其在老年患者中的应用证据仍存在争议。本研究旨在评估年龄≥80岁患者AF消融的安全性和有效性结果。对连续1327例首次接受AF肺静脉隔离(PVI)的患者进行回顾性分析。将年龄≥80岁的患者(老年组,n = 107)与年龄<80岁的患者(年轻组,n = 1220)进行比较。在1年随访时,老年组和年轻组的无房颤率无显著差异(72.0%对73.9%,P = 0.786)。关于主要并发症,老年患者围手术期卒中发生率更高(1.9%对0.1%,P = 0.018)。两组的心包填塞、膈神经麻痹和血管并发症发生率无显著差异。AF的PVI对年龄≥80岁的患者有效,成功率相似,但与年轻人群相比,围手术期卒中风险更高。

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