TY - JOUR
T1 - Arrhythmia profile and ablation-outcome in elderly women with atrial fibrillation undergoing first catheter ablation
AU - Natale, Veronica
AU - Mohanty, Sanghamitra
AU - Trivedi, Chintan
AU - Baqai, Faiz M.
AU - Gallinghouse, Joseph
AU - Della Rocca, Domenico Giovanni
AU - Gianni, Carola
AU - MacDonald, Bryan
AU - Mayedo, Angel
AU - Burkhardt, John David
AU - Gallinghouse, Gerald J.
AU - Al-Ahmad, Amin
AU - Horton, Rodney
AU - Bassiouny, Mohamed
AU - Di Biase, Luigi
AU - Natale, Andrea
N1 - Funding Information:
Dr. Natale is a consultant for Boston Scientific, Biosense Webster, St. Jude/Abbott Medical, Biotronik, Baylis and Medtronic. Dr. Di Biase is a consultant for Biosense Webster, Boston Scientific, Stereotaxis and St.Jude Medical. Dr Di Biase received speaker honoraria/travel support from Medtronic, Bristol Meyers Squibb, Pfizer and Biotronik.
Publisher Copyright:
© 2021 Wiley Periodicals LLC
PY - 2021/5
Y1 - 2021/5
N2 - 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.
AB - 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.
KW - ablation-outcome
KW - atrial fibrillation
KW - elderly
KW - non-PV triggers
KW - women
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U2 - 10.1111/pace.14223
DO - 10.1111/pace.14223
M3 - Article
C2 - 33742711
AN - SCOPUS:85103163312
SN - 0147-8389
VL - 44
SP - 835
EP - 842
JO - PACE - Pacing and Clinical Electrophysiology
JF - PACE - Pacing and Clinical Electrophysiology
IS - 5
ER -