Cardiovascular Implantable Electronic Devices -> Monitoring & Outcomes: -> Quality Measures & Complications D-PO06 - Poster Session VI (ID 26) Poster

D-PO06-013 - Safety And Efficacy Of Catheter Ablation For Atrial And Ventricular Arrhythmias In Octogenarians (ID 644)


Background: Catheter ablations are an established treatment for tachycardic arrhythmia. Although proven to be safe and effective in younger patients, there are few available data concerning the effectiveness and safety of catheter ablation procedures in elderly patients.
Objective: The purpose of this study was to determine procedural characteristics, short-term effectiveness and safety of interventional electrophysiological procedures in octogenarians.
Methods: We retrospectively studied 566 electrophysiological procedures performed on 486 different octogenarians and examined periprocedural complication rates.
Results: Mean patient age was 82.7±2.5 years, 481 patients were aged 80-85, 73 were aged 85-90, 10 were aged 90-95 and 2 patients were older than 95 years.The following procedures were performed: Atrial fibrillation (AF) ablation (256, 45.2%), ablation of the cavo-tricuspid isthmus (CTI) (139, 24.6%), ablation of supraventricular tachycardias (65, 11.5%), ablation of ventricular arrhythmias (57, 10.1 %), atrial tachycardia ablation (19, 3.4%), atrioventricular node ablation (n:17, 3.0%), diagnostic electrophysiological study (n:1, 0.2%). Occlusion of the left atrial appendage (LAAO) was performed in 12 patients (2.1%). Transseptal access was obtained in 327 procedures (57.8%).
A total of 33 major complications occurred during or after 31 procedures (5.5% of procedures; access site complications resulting in blood transfusion or interventional or surgical treatment in 14 cases, cardiac tamponade in 8 cases, pulmonary embolism, stroke, respiratory failure with need for invasive ventilation, AV block requiring permanent pacemaker implantation and pneumothorax treated by drain each occurred in 2 cases and phrenic nerve palsy in 1 case). Five patients died after the procedure (3 cases of cardiac tamponade, 1 pulmonary artery embolism, 1 pneumonia after aspiration during the ablation procedure).
Conclusion: Catheter ablations and LAAO can be performed with acceptably low rates of periprocedural complications in octogenarians, even in complex arrhythmias with the need for transseptal puncture and ventricular access.