Assessing Catheter ablation in very old patients with nonvalvular atrial fibrillation

Non-valvular atrial fibrillation (NVAF) is a common type of cardiac arrhythmia, specifically an irregular and often rapid heartbeat, that occurs in the upper chambers of the heart, known as the atria. The term "non-valvular" is used to distinguish this type of atrial fibrillation from another subtype called valvular atrial fibrillation, which is often associated with heart valve disorders.

Catheter ablation of atrial fibrillation (AF) is recommended for selected older patients. However, the preventive effects of AF ablation on cardiovascular events and death remain unclear, especially in older patients. In a new study, researchers from Kagawa Prefectural Central Hospital and Hyogo Medical University aimed to investigate the impact of AF ablation on the incidence of cardiovascular events and death in very old nonvalvular AF patients.

The researchers defined cardiovascular events as acute heart failure (AHF), strokes and systemic embolisms (SSEs), acute coronary syndrome (ACS), and sudden cardiac death (SCD) and cardiovascular death as AHF/SSE/ACS-related death and SCD. They compared the 3-year incidence of cardiovascular events and death between the patients who underwent AF ablation (Ablation group) and those who received medical therapy only (Medication group).

Among the 782 NVAF patients using direct oral anticoagulants, propensity score matching provided 208 patients in each group. The Ablation group had a significantly lower 3-year incidence of cardiovascular events and death than the Medication group: cardiovascular events, 24 vs. 43, and cardiovascular deaths, 5 vs. 15.

Reference: Cardiovascular events and death after catheter ablation in very old patients with nonvalvular atrial fibrillation, Aging-US, DOI 10.18632/aging.204952