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Volume 17 Issue 12
Dec.  2020
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Article Navigation >  Journal of Geriatric Cardiology  > 2020  >  17(12): 740-749
Xin SU, Xin DU, Shang-Xin LU, Chao JIANG, Jing DU, Shi-Jun XIA, Zhao-Jie DONG, Zhao-Xu JIA, De-Yong LONG, Cai-Hua SANG, Ri-Bo TANG, Nian LIU, Song-Nan LI, Rong BAI, Jian-Zeng DONG, Chang-Sheng MA. Catheter ablation for atrial fibrillation is associated with reduced risk of mortality in the elderly: a prospective cohort study and propensity score analysis. J Geriatr Cardiol 2020; 17(12): 740-749. doi: 10.11909/j.issn.1671-5411.2020.12.008
Citation: Xin SU, Xin DU, Shang-Xin LU, Chao JIANG, Jing DU, Shi-Jun XIA, Zhao-Jie DONG, Zhao-Xu JIA, De-Yong LONG, Cai-Hua SANG, Ri-Bo TANG, Nian LIU, Song-Nan LI, Rong BAI, Jian-Zeng DONG, Chang-Sheng MA. Catheter ablation for atrial fibrillation is associated with reduced risk of mortality in the elderly: a prospective cohort study and propensity score analysis. J Geriatr Cardiol 2020; 17(12): 740-749. doi: 10.11909/j.issn.1671-5411.2020.12.008
shu

Catheter ablation for atrial fibrillation is associated with reduced risk of mortality in the elderly: a prospective cohort study and propensity score analysis

doi: 10.11909/j.issn.1671-5411.2020.12.008
  • 1.

    Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, China

  • 2.

    Heart Health Research Center, Beijing, China

  • 3.

    The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia

  • 4.

    Beijing Centre for Disease Prevention and Control, Beijing, China

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  • Corresponding author:

    Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, China. E-mails: duxinheart@sina.com (DU X)

    Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, China. E-mails: chshma@vip.sina.com (MA CS)

  • Received Date: 2020-09-05
  • Accepted Date: 2020-12-09
  • Rev Recd Date: 2020-11-05
    • Available Online: 2020-12-28
  • Publish Date: 2020-12-26
    Abstract
  •  Background It is unclear whether catheter ablation (CA) for atrial fibrillation (AF) affects the long-term prognosis in the elderly. This study aims to evaluate the relationship between CA and long-term outcomes in elderly patients with AF. Methods Patients more than 75 years old with non-valvular AF were prospectively enrolled between August 2011 and December 2017 in the Chinese Atrial Fibrillation Registry Study. Participants who underwent CA at baseline were propensity score matched (1:1) with those who did not receive CA. The outcome events included all-cause mortality, cardiovascular mortality, stroke/transient ischemic attack (TIA), and cardiovascular hospitalization. Results Overall, this cohort included 571 ablated patients and 571 non-ablated patients with similar characteristics on 18 dimensions. During a mean follow-up of 39.75 ± 19.98 months (minimum six months), 24 patients died in the ablation group, compared with 60 deaths in the non-ablation group [hazard ratio (HR) = 0.49, 95% confidence interval (CI): 0.30-0.79, P = 0.0024]. Besides, 6 ablated and 29 non-ablated subjects died of cardiovascular disease (HR = 0.25, 95% CI: 0.11–0.61, P = 0.0022). A total of 27 ablated and 40 non-ablated patients suffered stroke/TIA (HR = 0.79, 95% CI: 0.48–1.28, P = 0.3431). In addition, 140 ablated and 194 non-ablated participants suffered cardiovascular hospitalization (HR = 0.84, 95% CI: 0.67–1.04, P = 0.1084). Subgroup analyses according to gender, type of AF, time since onset of AF, and anticoagulants exposure in initiation did not show significant heterogeneity. Conclusions In elderly patients with AF, CA may be associated with a lower incidence of all-cause and cardiovascular mortality.
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