Risk and Outcome after Ablation of Isthmus-Dependent Atrial Flutter in Elderly Patients - Archive ouverte HAL Access content directly
Journal Articles PLoS ONE Year : 2015

Risk and Outcome after Ablation of Isthmus-Dependent Atrial Flutter in Elderly Patients

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Abstract

Purpose of the research To study the influence of age on the clinical presentation and long-term outcome of patients referred for atrial flutter (AFL) ablation. Age-related differences have been reported regarding the prognosis of arrhythmias. Methods A total of 1187 patients with a mean age 65±12 years consecutively referred for AFL abla-tion were retrospectively analyzed in the study. Results 445 (37.5%) patients were aged 70 (range 70 to 93) among which 345 were aged 70 to 79 years (29.1%) and 100 were aged 80 (8.4%). In multivariable analysis, AFL-related rhythmic cardiomyopathy and presentation with 1/1 AFL were less frequent (respectively adjusted OR = 0.44, 0.27–0.74, p = 0.002 and adjusted OR = 0.29, 0.16–0.52, p<0.0001). AFL ablation-related major complications were more frequent in patients 70 although remained lower than 10% (7.4% in 70 vs. 4.2% in <70, adjusted OR = 1.74, 1.04–2.89, p = 0.03). After 2.1±2.7 years, AFL recurrence was less frequent in patients 70 (adjusted OR = 0.54, 0.37–0.80, p = 0.002) whereas atrial fibrillation (AF) occurrence was as frequent in the 70– 79 and 80 age subsets. As expected, cardiac mortality was higher in older patients. Patients aged 80 also had a low probability of AFL recurrence (5.0%) and AF onset (19.0%). Conclusions Older patients represent 37.5% of patients referred for AFL ablation and displayed a <10% risk of ablation-related complications. Importantly, AFL recurrences were less frequent in patients 70 while AF occurrence was as frequent as in patients <70. Similar observations were made in patients 80 years. AFL ablation appears to be safe and efficient and should not be ruled out in elderly patients.
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hal-01731010 , version 1 (13-03-2018)

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Béatrice Brembilla-Perrot, Jean Sellal, Arnaud Olivier, Vladimir Manenti, Thibault Villemin, et al.. Risk and Outcome after Ablation of Isthmus-Dependent Atrial Flutter in Elderly Patients. PLoS ONE, 2015, 10 (5), pp.e0127672. ⟨10.1371/journal.pone.0127672⟩. ⟨hal-01731010⟩
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