Introduction: Atrial fibrillation (AF) is the most common arrhythmia among elderly patients (over 75 years according to the WHO classification, 2015). Catheter ablation (CA) is one of the most common treatments for AF, but this method is not widely used in the treatment of elderly age persons with AF.
Purpose: To evaluate the efficacy and safety of CA for AF treatment in elderly patients.
Materials and methods: Data from 51 patients with AF, who were 75 years old and older, who received treatment at the Scientific Research Institute of Cardiology and Internal Diseases, Almaty from April 2014 to December 2018 were analysed. The study included 32 patients, for whom as a treatment strategy was chosen CA. Complications associated with CA, as well as the duration of sinus rhythm restore after the procedure were analysed. Then we made retrospective comparison of the obtained results with similar indicators obtained from comparison group of 110 patients younger than 75 years old, for whom CA also was chose as a treatment strategy.
Results: The average age of elderly patients was 77.2 ± 2.5. 13 (40.6%) women, 12 (37.5%) had a persistent form of AF. The average duration of AF was 5 years (interquartile range: 2.5, 10). The mean follow-up was 395 days (interquartile range: 182, 777). Complications of the procedure included: two cases of cardiac tamponade during ablation (CA was not completed), five cases of complications associated with puncture of the femoral vein, two cases of hemodynamically insignificant hydropericardium. After CA, 21 (65.6%) patients had sinus rhythm during the entire observation period. The frequency of complications compared with the group of patients younger than 75 years was comparable (28.5% versus 27.1%, p=1.00). When analysing the Kaplan-Meier curve, there was no significant difference in the AF recurrence rate in two groups (34.4% versus 32.0%, p=0.57).
Conclusions: CA is an effective and safe method AF treating in elderly patients. Further studies are needed to assess the effect of CA on the survival and quality of life of elderly patients.