Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(10), 1202–1209. https://doi.org/10.1002/clc.24099 Dr. Peng-Pai Zhang et al.
Points
- Combining catheter ablation (CA) with left atrial appendage occlusion (LAAO) is a feasible treatment option for atrial fibrillation (AF) patients over 80 years old.
- Octogenarian patients had a higher prevalence of paroxysmal AF and a higher CHA2DS2VASc score compared to non-octogenarian patients.
- The combination of CA and LAAO showed comparable efficacy in restoring sinus rhythm between octogenarian and non-octogenarian patients.
- The annual thromboembolic risk was slightly higher in the octogenarian group, but overall safety outcomes were similar between the two groups.
- Further research and more extensive studies are needed to validate these findings and explore the long-term benefits of combining CA and LAAO in octogenarian AF patients.
Summary
This single-center retrospective study aimed to evaluate the feasibility and outcomes of combining catheter ablation (CA) with left atrial appendage occlusion (LAAO) in atrial fibrillation (AF) patients over 80 years old. The study included 505 patients who underwent CA and LAAO between March 2018 and December 2020. Efficacy endpoints included procedural success rate, AF recurrence rate, and thromboembolic events, while safety endpoints included pericardial effusion/cardiac tamponade, device-related thrombus (DRT), all-cause death, and significant bleeding.
Among the included patients, 46 (9.1%) were octogenarians. Octogenarian patients had a higher prevalence of paroxysmal AF and a higher CHA2DS2VASc score compared to non-octogenarian patients. Pericardial effusion occurred in six cases, all in non-octogenarian patients. At three months post-procedure, most octogenarian and non-octogenarian patients had no peri-device leak. AF recurrence rates were similar between the two groups after a mean follow-up of 26.9 months. The annual thromboembolic risk was slightly higher in the octogenarian group. Death occurred in 16 non-octogenarian patients, while one major bleeding event was recorded in the octogenarian group.
In conclusion, combining CA and LAAO in a single procedure is a feasible treatment option for octogenarian AF patients, with comparable efficacy and safety outcomes to non-octogenarian patients. These findings suggest that this approach can effectively restore sinus rhythm and prevent stroke in this age group. Further research and more extensive studies are warranted to validate these results and explore the long-term benefits of this combined intervention.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24099
References Zhang, P., Zhao, Y., Sun, J., Wang, Q., Li, W., Zhang, R., Chen, M., Mo, B., Yu, Y., Feng, X., Liu, B., Yu, Y., Lu, Q., & Li, Y. (2023). Safety and efficacy of ablation for atrial fibrillation in combination with left atrial appendage occlusion in octogenarians. Clinical Cardiology, 46(10), 1202–1209. https://doi.org/10.1002/clc.24099
