Arrhythmia profile and ablation-outcome in elderly women with atrial fibrillation undergoing first catheter ablation

Veronica Natale, Sanghamitra Mohanty, Chintan Trivedi, Faiz M. Baqai, Joseph Gallinghouse, Domenico Giovanni Della Rocca, Carola Gianni, Bryan MacDonald, Angel Mayedo, John David Burkhardt, Gerald J. Gallinghouse, Amin Al-Ahmad, Rodney Horton, Mohamed Bassiouny, Luigi Di Biase, Andrea Natale

Research output: Contribution to journalArticlepeer-review

Abstract

Background: This study evaluated the arrhythmia profile and ablation outcome in women with atrial fibrillation (AF) aged ≥75 years. Methods: A total of 573 consecutive female patients undergoing first AF ablation were classified into group 1: ≥75 years (n = 221) and group 2: < 75 years (n = 352). Isolation of PVs, posterior wall and superior vena cava was performed in all. Non-PV triggers from other areas were ablated based on operator's discretion. Results: Group 1 had higher prevalence of hypertension (154 (69.7%) vs. 188 (53.4%), p <.001) and non-paroxysmal AF (136 (61.5%) vs. 126 (35.8%), p <.001). Non-PV triggers were detected in 194 (87.8%) patients from group 1 and 143 (40.6%) from group 2 (p <.001) and were ablated in 152 (68.8%) and 114 (32.4%) from group 1 and 2 respectively. Remaining patients (group 1: 69/221 and group 2: 238/352) received no additional ablation. At 4 years, 109 (49.3%) and 185 (52.6%) from group 1 and 2, respectively, were arrhythmia-free, p =.69. When stratified by ablation-strategy, success-rate was similar across groups in patients receiving non-PV trigger ablation (96 (63.2%) in group 1 and 76 (66.7%) in group 2, p =.61), whereas it was significantly lower in group 1 patients not receiving additional ablation compared to those from group 2 (13 (18.8%) vs. 109 (45.8%), p <.001). Conclusion: Non-paroxysmal AF was more common in women aged ≥75 years. Furthermore, significantly higher number of non-PV triggers were detected in elderly women and ablation of those provided similar ablation success as that in women aged < 75 years.

Original languageEnglish (US)
Pages (from-to)835-842
Number of pages8
JournalPACE - Pacing and Clinical Electrophysiology
Volume44
Issue number5
DOIs
StatePublished - May 2021

Keywords

  • ablation-outcome
  • atrial fibrillation
  • elderly
  • non-PV triggers
  • women

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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