Sawalha Khalid, Kadado Anis John, Pundlik Shayal, Gobeil Kyle, Abdelazeem Mohamed, Chalhoub Fadi
Department of Cardiology, UMass Chan Medical School - Baystate, Springfield, MA, USA.
Department of Cardiology, Yale University, New Haven, CT, USA.
J Innov Card Rhythm Manag. 2025 Aug 15;16(8):6412-6419. doi: 10.19102/icrm.2025.16084. eCollection 2025 Aug.
Catheter ablation has emerged as a first-line therapy for many arrhythmias. However, data on the safety and outcomes of catheter ablation in the elderly population remain limited. Here, we aimed to study the outcomes of catheter ablation in octogenarians. The data used in this study were obtained from the National Inpatient Sample database through years 2016-2019. We identified patients ≥80 years old who were diagnosed with atrial fibrillation (AF), atrial flutter (AFL), supraventricular tachycardia (SVT), or ventricular tachycardia (VT) as primary diagnoses. The patients' characteristics and common procedure complications were extracted. We investigated the predictors of mortality and in-hospital complications using multivariable logistic regression. A total of 18,595 patients were included in our analysis. The most common procedure performed was ablation for AF (46%), followed by AFL ablation (23%), VT ablation (18%), and SVT ablation (12%). Higher rates of tamponade (1.6%) were seen in patients undergoing VT ablation. A Charlson's comorbidity index (CCI) score of ≥3 points was used as an independent predictor for complications (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.4-3.3, = .001). Mortality was higher in VT ablation (4.2%) compared to AFL (1.3%), AF (0.9%), and SVT (0.3%). After logistic regression analysis, a CCI score of ≥3 points (OR, 14.7; 95% CI, 1.88-114.9; = .01) and tamponade (OR, 4.9; 95% CI, 1.65-14.8; = .004) were independent predictors of mortality. We found a low incidence of procedural complication rates across all ablation groups in octogenarians. Those undergoing VT ablation were more likely to have complications and a higher mortality rate. Baseline comorbidities can be used to risk-stratify patients when deciding on the best treatment strategy.
导管消融已成为许多心律失常的一线治疗方法。然而，关于老年人群导管消融安全性和结果的数据仍然有限。在此，我们旨在研究八旬老人导管消融的结果。本研究中使用的数据通过2016 - 2019年从国家住院样本数据库中获取。我们确定年龄≥80岁且被诊断为心房颤动（AF）、心房扑动（AFL）、室上性心动过速（SVT）或室性心动过速（VT）作为主要诊断的患者。提取患者的特征和常见手术并发症。我们使用多变量逻辑回归研究死亡率和住院并发症的预测因素。我们的分析共纳入了18595例患者。最常进行的手术是AF消融（46%），其次是AFL消融（23%）、VT消融（18%）和SVT消融（12%）。接受VT消融的患者心包填塞发生率较高（1.6%）。使用Charlson合并症指数（CCI）评分≥3分作为并发症的独立预测因素（比值比[OR]，2.14；95%置信区间[CI]，1.4 - 3.3，P = 0.001）。与AFL（1.3%）、AF（0.9%）和SVT（0.3%）相比，VT消融的死亡率更高（4.2%）。经过逻辑回归分析，CCI评分≥3分（OR，14.7；95% CI，1.88 - 114.9；P = 0.01）和心包填塞（OR，4.9；95% CI，1.65 - 14.8；P = 0.004）是死亡率的独立预测因素。我们发现八旬老人所有消融组的手术并发症发生率较低。接受VT消融的患者更有可能出现并发症且死亡率更高。在决定最佳治疗策略时，基线合并症可用于对患者进行风险分层。
