The impact of age on the electroanatomical characteristics and outcome of catheter ablation in patients with atrial fibrillation

Ta Chuan Tuan, Shih Lin Chang, Hsuan Ming Tsao, Ching Tai Tai, Yenn Jiang Lin, Yu Feng Hu, Li Wei Lo, Ameya R. Udyavar, Chien Jong Chang, Wen Chin Tsai, Wei Hua Tang, Kazuyoshi Suenari, Shih Yu Huang, Pi Change Lee, Shih Ann Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

55 Scopus citations

Abstract

Age and Atrial Fibrillation. Background: Previous studies have indicated that atrial fibrillation (AF) in patients over the age of 60 at diagnosis is a risk factor for a substantial increase in cardiovascular events. However, information about the impact of age on the atrial substrate and clinical outcome after catheter ablation of AF is limited. Methods: This study included 350 patients (53 ± 12 years, 254 males) who underwent circumferential pulmonary vein isolation (CPVI) of AF, guided by a NavX mapping system. The subjects were divided into three groups according to their age, as follows: Group I: age ≤50 (n = 141), Group II: age = 51-64 (n = 149) and Group III: age ≥65 years old (n = 60). The mean voltage and total activation time of the individual atria were obtained by using a NavX mapping system before ablation. Several parameters, including the gender, AF duration, and left atrial (LA) diameter were analyzed. Results: The younger age group had a significantly smaller LA diameter (Group I vs Group II vs Group III, 36.89 ± 7.11 vs 39.16 ± 5.65 vs 40.77 ± 4.95 mm, P = 0.002) and higher LA bipolar voltage (2.09 ± 0.83 vs 1.73 ± 0.73 vs 1.86 ± 0.67 mV, respectively, P = 0.024), compared with the older AF patients. The LA bipolar voltage exhibited a significant reduction when the patients became older, however, that did not occur in the right atrium. The incidence of an AF recurrence was higher in the older age group than in the younger age groups. A subgroup of patients with lone AF was analyzed and age was found to be an independent predictor of the AF recurrence after receiving the first CPVI in the multivariable model (P < 0.05). Conclusions: Age has a significant impact on the LA substrate properties and outcome of the catheter ablation of AF.

Original languageEnglish
Pages (from-to)966-972
Number of pages7
JournalJournal of cardiovascular electrophysiology
Volume21
Issue number9
DOIs
StatePublished - Sep 2010

Keywords

  • age
  • atrial fibrillation
  • pulmonary vein isolation
  • radiofrequency ablation
  • voltage

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