Safety of catheter ablation for atrial fibrillation in the octogenarian population

Jorge Romero, Gbolahan Ogunbayo, Samy C. Elayi, Yousef Darrat, Saul A. Rios, Juan C. Diaz, Isabella Alviz, Luis Cerna, Mohamed Gabr, Elizabeth Chernobelsky, Sanghamitra Mohanty, Chintan G. Trivedi, Domenico G. Della Rocca, Andrea Natale, Luigi Di Biase

Research output: Contribution to journalArticle

Abstract

Introduction: Catheter ablation (CA) has been shown to be an effective treatment for atrial fibrillation (AF). The complication rates and outcomes among octogenarians remain poorly studied. We aimed to compare trends, morbidity, and mortality associated with CA for AF among octogenarians versus those less than 80 years old. Methods: Using weighted sampling from the National Inpatient Sample database, we identified patients with a primary diagnosis of AF and a primary procedure of CA (2004-2013). Our primary outcome was mortality. Secondary outcomes included incidence of major and minor complications. Results: Among 86,119 patients who underwent CA for AF, 3,482 were 80 years old or older. Complications were significantly more frequent in octogenarians; [16.2% (564 of 3,482) versus 9.8% (8,092 of 82,637), P < 0.001]. Of note, there was no significant difference for the composite of major complications; [3.6% (124 of 3482) in octogenarians versus 2.8% (2286 of 82637), P = 0.20]. The total mortality rate was not significant in a multivariate regression analysis (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.35-2.64; P =.94). The presence of chronic renal failure (OR, 4.19; 95% CI, 2.75-6.36; P < 0.001), anemia (OR, 1.75; 95% CI, 1.03-2.97; P =.04), and chronic pulmonary disease (OR, 1.75; 95% CI, 1.11-2.62; P =.015) were predictors of major complications in octogenarians. Conclusion: Catheter ablation for AF in octogenarians does not confer a higher mortality risk than in those less than 80 years old. The procedure is associated with a higher rate of overall complications but there was no difference in terms of major complications or death. The presence of anemia, CKD or pulmonary disease were predictors of major complications in octogenarians.

Original languageEnglish (US)
JournalJournal of Cardiovascular Electrophysiology
DOIs
StateAccepted/In press - Jan 1 2019

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Catheter Ablation
Atrial Fibrillation
Safety
Population
Odds Ratio
Confidence Intervals
Mortality
Lung Diseases
Anemia
Chronic Kidney Failure
Inpatients
Chronic Disease
Multivariate Analysis
Regression Analysis
Databases
Morbidity
Incidence

Keywords

  • atrial fibrillation
  • catheter ablation
  • complication rate
  • octogenarian

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Safety of catheter ablation for atrial fibrillation in the octogenarian population. / Romero, Jorge; Ogunbayo, Gbolahan; Elayi, Samy C.; Darrat, Yousef; Rios, Saul A.; Diaz, Juan C.; Alviz, Isabella; Cerna, Luis; Gabr, Mohamed; Chernobelsky, Elizabeth; Mohanty, Sanghamitra; Trivedi, Chintan G.; Della Rocca, Domenico G.; Natale, Andrea; Di Biase, Luigi.

In: Journal of Cardiovascular Electrophysiology, 01.01.2019.

Research output: Contribution to journalArticle

Romero, J, Ogunbayo, G, Elayi, SC, Darrat, Y, Rios, SA, Diaz, JC, Alviz, I, Cerna, L, Gabr, M, Chernobelsky, E, Mohanty, S, Trivedi, CG, Della Rocca, DG, Natale, A & Di Biase, L 2019, 'Safety of catheter ablation for atrial fibrillation in the octogenarian population', Journal of Cardiovascular Electrophysiology. https://doi.org/10.1111/jce.14165
Romero, Jorge ; Ogunbayo, Gbolahan ; Elayi, Samy C. ; Darrat, Yousef ; Rios, Saul A. ; Diaz, Juan C. ; Alviz, Isabella ; Cerna, Luis ; Gabr, Mohamed ; Chernobelsky, Elizabeth ; Mohanty, Sanghamitra ; Trivedi, Chintan G. ; Della Rocca, Domenico G. ; Natale, Andrea ; Di Biase, Luigi. / Safety of catheter ablation for atrial fibrillation in the octogenarian population. In: Journal of Cardiovascular Electrophysiology. 2019.
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abstract = "Introduction: Catheter ablation (CA) has been shown to be an effective treatment for atrial fibrillation (AF). The complication rates and outcomes among octogenarians remain poorly studied. We aimed to compare trends, morbidity, and mortality associated with CA for AF among octogenarians versus those less than 80 years old. Methods: Using weighted sampling from the National Inpatient Sample database, we identified patients with a primary diagnosis of AF and a primary procedure of CA (2004-2013). Our primary outcome was mortality. Secondary outcomes included incidence of major and minor complications. Results: Among 86,119 patients who underwent CA for AF, 3,482 were 80 years old or older. Complications were significantly more frequent in octogenarians; [16.2{\%} (564 of 3,482) versus 9.8{\%} (8,092 of 82,637), P < 0.001]. Of note, there was no significant difference for the composite of major complications; [3.6{\%} (124 of 3482) in octogenarians versus 2.8{\%} (2286 of 82637), P = 0.20]. The total mortality rate was not significant in a multivariate regression analysis (odds ratio [OR], 0.96; 95{\%} confidence interval [CI], 0.35-2.64; P =.94). The presence of chronic renal failure (OR, 4.19; 95{\%} CI, 2.75-6.36; P < 0.001), anemia (OR, 1.75; 95{\%} CI, 1.03-2.97; P =.04), and chronic pulmonary disease (OR, 1.75; 95{\%} CI, 1.11-2.62; P =.015) were predictors of major complications in octogenarians. Conclusion: Catheter ablation for AF in octogenarians does not confer a higher mortality risk than in those less than 80 years old. The procedure is associated with a higher rate of overall complications but there was no difference in terms of major complications or death. The presence of anemia, CKD or pulmonary disease were predictors of major complications in octogenarians.",
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T1 - Safety of catheter ablation for atrial fibrillation in the octogenarian population

AU - Romero, Jorge

AU - Ogunbayo, Gbolahan

AU - Elayi, Samy C.

AU - Darrat, Yousef

AU - Rios, Saul A.

AU - Diaz, Juan C.

AU - Alviz, Isabella

AU - Cerna, Luis

AU - Gabr, Mohamed

AU - Chernobelsky, Elizabeth

AU - Mohanty, Sanghamitra

AU - Trivedi, Chintan G.

AU - Della Rocca, Domenico G.

AU - Natale, Andrea

AU - Di Biase, Luigi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Introduction: Catheter ablation (CA) has been shown to be an effective treatment for atrial fibrillation (AF). The complication rates and outcomes among octogenarians remain poorly studied. We aimed to compare trends, morbidity, and mortality associated with CA for AF among octogenarians versus those less than 80 years old. Methods: Using weighted sampling from the National Inpatient Sample database, we identified patients with a primary diagnosis of AF and a primary procedure of CA (2004-2013). Our primary outcome was mortality. Secondary outcomes included incidence of major and minor complications. Results: Among 86,119 patients who underwent CA for AF, 3,482 were 80 years old or older. Complications were significantly more frequent in octogenarians; [16.2% (564 of 3,482) versus 9.8% (8,092 of 82,637), P < 0.001]. Of note, there was no significant difference for the composite of major complications; [3.6% (124 of 3482) in octogenarians versus 2.8% (2286 of 82637), P = 0.20]. The total mortality rate was not significant in a multivariate regression analysis (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.35-2.64; P =.94). The presence of chronic renal failure (OR, 4.19; 95% CI, 2.75-6.36; P < 0.001), anemia (OR, 1.75; 95% CI, 1.03-2.97; P =.04), and chronic pulmonary disease (OR, 1.75; 95% CI, 1.11-2.62; P =.015) were predictors of major complications in octogenarians. Conclusion: Catheter ablation for AF in octogenarians does not confer a higher mortality risk than in those less than 80 years old. The procedure is associated with a higher rate of overall complications but there was no difference in terms of major complications or death. The presence of anemia, CKD or pulmonary disease were predictors of major complications in octogenarians.

AB - Introduction: Catheter ablation (CA) has been shown to be an effective treatment for atrial fibrillation (AF). The complication rates and outcomes among octogenarians remain poorly studied. We aimed to compare trends, morbidity, and mortality associated with CA for AF among octogenarians versus those less than 80 years old. Methods: Using weighted sampling from the National Inpatient Sample database, we identified patients with a primary diagnosis of AF and a primary procedure of CA (2004-2013). Our primary outcome was mortality. Secondary outcomes included incidence of major and minor complications. Results: Among 86,119 patients who underwent CA for AF, 3,482 were 80 years old or older. Complications were significantly more frequent in octogenarians; [16.2% (564 of 3,482) versus 9.8% (8,092 of 82,637), P < 0.001]. Of note, there was no significant difference for the composite of major complications; [3.6% (124 of 3482) in octogenarians versus 2.8% (2286 of 82637), P = 0.20]. The total mortality rate was not significant in a multivariate regression analysis (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.35-2.64; P =.94). The presence of chronic renal failure (OR, 4.19; 95% CI, 2.75-6.36; P < 0.001), anemia (OR, 1.75; 95% CI, 1.03-2.97; P =.04), and chronic pulmonary disease (OR, 1.75; 95% CI, 1.11-2.62; P =.015) were predictors of major complications in octogenarians. Conclusion: Catheter ablation for AF in octogenarians does not confer a higher mortality risk than in those less than 80 years old. The procedure is associated with a higher rate of overall complications but there was no difference in terms of major complications or death. The presence of anemia, CKD or pulmonary disease were predictors of major complications in octogenarians.

KW - atrial fibrillation

KW - catheter ablation

KW - complication rate

KW - octogenarian

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