Safety and efficacy of cryoballoon ablation for the treatment of atrial fibrillation in elderly patients

Abdin, Amr; Yalın, Kıvanç; Lyan, Evgeny; Sawan, Noureddin; Liosis, S L; Meyer‐Saraei, Roza; Elsner, Christian; Lange, Stefan; Heeger, Christian‐Hendrik; Eitel, Charlotte; Eitel, Ingo; Tilz, Roland Richard

doi:10.1007/s00392-018-1336-x

Cited by 38 publications

(43 citation statements)

References 23 publications

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“…First, CB‐A can reduce procedure time. According to previous reports, the efficacy of PVI with CB‐A might be comparable to that of PVI with RF‐CA in patients with AF greater than 75 years and may involve a shorter procedure time. Procedure and fluoroscopy times were comparable between the groups in this study population.…”

Section: Discussionmentioning

confidence: 86%

“…In this study, we found that the main finding is that CB‐A is a safe and effective procedure for the treatment of AF in patients ≥80 years, granting freedom from AF/AT recurrence in 86.8% of patients at 1 year after ablation. To our knowledge, although several reports have described the efficacy and safety of CB‐A in elderly patients greater than 75 years, our present study is the first to compare the efficacy and safety of CB‐A in patients aged ≥80 years with a cohort younger than 80 years.…”

Section: Discussionmentioning

confidence: 95%

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Efficacy and safety of the cryoballoon‐based atrial fibrillation ablation in patients aged ≥80 years

Kanda

Masuda

Kurata

et al. 2019

Cardiovasc electrophysiol

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Introduction The prevalence of atrial fibrillation (AF) increases with age. Although the efficacy of cryoballoon ablation (CB‐A) in patients with AF has been demonstrated, data on the efficacy of this CB‐A in elderly patients are limited. The aim of this study was to evaluate the 1‐year efficacy and safety of CB‐A in patients aged ≥80 years compared with those less than 80 years. Methods A total of 49 consecutive patients ≥80 years with paroxysmal AF (PAF) who underwent CB‐A were compared with 241 patients aged <80 years. AF‐free survival rate at 1 year and procedural data were compared between the groups. Results Median (25th, 75th quartile) age was 83 (82, 85) years in the older group and 68 (61, 73) years in the younger group. At 1‐year follow‐up, the success rate did not significantly differ between the groups. In Cox regression analysis, age ≥80 years was not significantly related to AF recurrence. Low‐voltage areas were more frequently observed in the elderly group than the control group (39% vs 17%; P = .01). Fluoroscopy time and procedure time did not differ significantly. There was no significant difference in the occurrence rate of transient phrenic nerve palsy. No severe complications occurred in either group, including procedure‐related deaths, atrioesophageal fistula, cardiac tamponade, and cerebrovascular embolic events. Conclusion The results of our study showed that CB‐A for PAF is a feasible and safe procedure even in elderly patients, with similar success and complication rates when compared with a younger population.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 95%

Efficacy and safety of the cryoballoon‐based atrial fibrillation ablation in patients aged ≥80 years

Kanda

Masuda

Kurata

et al. 2019

Cardiovasc electrophysiol

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“…Our results serve to extend and confirm those of a number of prior publications that have reported the outcomes of cryoballoon ablation in elderly patients with AF. [ 7 – 16 ] The definition of ‘elderly’ in these series included patients aged as young as 70 years, and the reported success rates range from 62 to 87%. In the aggregate, these studies have investigated safety and efficacy rates at 1 year in a total of 2,235 patients.…”

Section: Discussionmentioning

confidence: 99%

Cryoballoon Ablation of Atrial Fibrillation in Octogenarians

Akhtar

Berger

Marine

et al. 2020

Arrhythmia &Amp; Electrophysiology Review

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A significant proportion of AF patients with advanced age are being treated in clinical practice. Cryoballoon ablation of AF, given its shorter procedure time and comparable efficacy to radiofrequency ablation, has rapidly become a commonly used tool for AF ablation. Data regarding the outcomes of cryoballoon ablation of AF in octogenarians are limited because of the exclusion of this age group in the previous studies. The authors report outcomes of 15 octogenarian AF patients undergoing index cryoballoon ablation at a single centre. The mean age of the included patients was 83 ± 3 years. In total, 13 patients (87%) presented with paroxysmal AF, and two (13%) had long-standing persistent AF. At 6 and 12 months of follow-up, freedom from AF was 80% and 70%, respectively. None of the patients suffered any procedure-related complications. Cryoballoon ablation appears to be a safe and effective approach for treating symptomatic AF refractory to antiarrhythmic drug therapy in octogenarian patients, based on outcomes in this cohort. These findings require further validation in prospective randomised studies with larger sample sizes.

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“…Given the rising proportion of elderly patients with AF, the utilization of CA in elderly patients is growing. Numerous studies have investigated the outcomes of CA of AF in elderly patients, and the mean age of the included patients is variable [4][5][6][7][8][9][10][11][12][13] . To the best of our knowledge, ours is the first study from the US to compare the outcomes of CB vs. RF AF ablation in elderly patients.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Cryoballoon versus Radiofrequency Ablation for Atrial Fibrillation in Elderly Patients and Predictors of Arrhythmia Recurrence

Akhtar¹,

Daimee²,

Sivasambu³

et al. 2020

Preprint

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Introduction: There are limited data describing the experience of index radiofrequency (RF) vs. cryoballoon (CB) ablation for atrial fibrillation (AF) among elderly patients in the United States. Methods: We conducted a retrospective analysis of patients > 75 years of age undergoing index AF ablation between January 2010 and March 2019 at our center. Major complications and efficacy, defined as freedom from any atrial tachyarrhythmia (ATA) lasting ≥30 seconds after one year of follow-up, were assessed in patients with index RF vs. CB ablation. Predictors of ATA recurrence at 1 year follow-up were also evaluated. Results: In our cohort of 194 patients, the mean age was 78 ± 3.1 years, 58.2% were men, and 39.4% had persistent AF. The mean left atrial (LA) diameter was 4.5 ± 0.7, while the mean CHA2DS2-VASc score was 3.5 ± 1.2. The majority (n=149, 76.8%) underwent RF ablation. The incidence of complications was similar in the two sub-groups (RF: 1.3% vs. CB: 2.2%, p=0.67). No significant difference in success rate at 1-year follow-up was found between patients receiving RF vs. CB ablation (59.7% vs. 66.7%, p=0.68). In a multivariable model adjusting for the relevant covariates only LA size [HR=1.64, CI: 1.15-2.34, p<0.01] was independently associated with ATA recurrence at 1year follow-up. Conclusion: In our cohort of elderly patients undergoing index CA for AF, RF ablation was the predominant modality with similar safety and efficacy relative to CB ablation. LA size was a significant predictor of ATA recurrence at 1year independent of index ablation modality.

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Safety and efficacy of cryoballoon ablation for the treatment of atrial fibrillation in elderly patients

Abstract: Our data strengthen the value of CB ablation for the treatment of AF as an effective and safe procedure in elderly patients, with similar success and complication rates when compared with a younger population.

Cited by 38 publications

References 23 publications

Efficacy and safety of the cryoballoon‐based atrial fibrillation ablation in patients aged ≥80 years

Efficacy and safety of the cryoballoon‐based atrial fibrillation ablation in patients aged ≥80 years

Cryoballoon Ablation of Atrial Fibrillation in Octogenarians

Safety and Efficacy of Cryoballoon versus Radiofrequency Ablation for Atrial Fibrillation in Elderly Patients and Predictors of Arrhythmia Recurrence

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