Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(7), 794–800. https://doi.org/10.1002/clc.24031 Dr. Hideharu Okamatsu et al.
Points
- A retrospective study compared AI-guided atrial fibrillation (AF) ablation in two age groups: ≥80 years (Group 1) and <80 years (Group 2), using data from 2087 patients.
- Group 1 had a higher mean age of 83.0 years compared to 67.0 years in Group 2, and there was a significant difference in AF type distribution between the groups.
- Unadjusted data showed similar atrial tachyarrhythmia (AT) recurrence rates in both groups and after adjusting for AF type, survival curves remained comparable.
- The study revealed no significant difference in procedure-related complications between Group 1 (3.1%) and Group 2 (3.0%).
- In conclusion, AI-guided AF ablation demonstrated comparable efficacy and safety in elderly AF patients aged ≥80 and younger patients aged <80 years, highlighting its potential as a viable treatment option for octogenarians.
Summary
This retrospective study aimed to assess the efficacy and safety of atrial fibrillation (AF) ablation guided by an ablation index (AI) in two distinct age groups: patients aged ≥80 years (Group 1) and those aged <80 years (Group 2), utilizing data from a cohort of 2087 AF patients undergoing their first AI-guided AF ablation.
The mean age in Group 1 was notably higher at 83.0 years compared to the mean age of 67.0 years in Group 2. Furthermore, there was a substantial disparity in the distribution of AF types between the two groups. In Group 1, 62.2% had paroxysmal AF, 31.6% had persistent AF, and 6.2% had long-standing persistent AF. In contrast, Group 2 had 53.6% paroxysmal AF, 30.7% persistent AF, and 15.6% long-standing persistent AF. This distinction in AF-type distribution was statistically significant (p = .001).
Regarding the primary outcomes, unadjusted atrial tachyarrhythmia (AT) recurrence-free survival curves displayed no substantial difference between the two groups (p = .67 by log-rank test). After adjusting for AF type, the survival curve remained similar between the groups (hazard ratio, 1.24; 95% CI [0.92–1.65]; p = .15, Group 1 vs. Group 2). Notably, the rate of procedure-related complications was comparable between the two groups, with a prevalence of 3.1% in Group 1 and 3.0% in Group 2 (p = .83).
In conclusion, the study’s findings indicate that AI-guided catheter ablation for AF yielded similar AT recurrence rates and procedure-related complications in elderly AF patients aged ≥80 and their younger counterparts aged <80. These results underscore the potential of AI-guided AF ablation as an effective and safe treatment option, particularly in octogenarian patients, and offer valuable insights into the management of AF in elderly populations.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24031
References Okamatsu, H., Okumura, K., Onishi, F., Yoshimura, A., Negishi, K., Tsurugi, T., Tanaka, Y., Nakao, K., Sakamoto, T., & Koyama, J. (2023). Safety and efficacy of ablation index‐guided atrial fibrillation ablation in octogenarians. Clinical Cardiology, 46(7), 794–800. https://doi.org/10.1002/clc.24031
