Deaths differed in persistent atrial fibrillation patients 75 or older
Five-year mortality was 11.5% with pulmonary vein isolation versus 22.4% with node ablation and pacing in matched patients aged 75 and older with persistent atrial fibrillation.
32,808 participants
Limit: Deaths in the first 90 days after each procedure were omitted
Edited by Boris Djordjevic · AgingResearch.News
Patients aged 75 and older with persistent atrial fibrillation, an ongoing irregular heartbeat, were compared in an observational study using US health records. Researchers matched two groups of 3,285 patients. Their average age was 84; 63% were female. One group underwent pulmonary vein isolation, a procedure that blocks abnormal electrical signals. The other underwent atrioventricular nodal ablation with pacemaker implantation.
Outcomes were assessed starting 90 days after each procedure. Over five years, vein isolation was associated with lower mortality: 11.5% versus 22.4%. Heart failure hospitalization rates were 38.8% versus 43.0%. However, overall hospitalization rates were higher: 59.7% versus 56.4%. A combined outcome occurred in 70.0% versus 60.5%. It included hospitalization for atrial fibrillation or heart failure, electrical procedures to restore heart rhythm, or an upgrade to pacing that coordinates the heart’s pumping chambers. All comparisons were with nodal ablation and pacing.
Why it matters
Choosing between procedures for persistent atrial fibrillation remains an unresolved question in older patients. The findings highlight trade-offs that prospective studies could examine to improve patient selection.
Caveats
This observational analysis could not rule out unmeasured differences between groups. Reported as a conference abstract, it covered patients aged 75 and older with persistent atrial fibrillation, not younger people or those with intermittent episodes.
- Pulmonary vein isolation
- Persistent atrial fibrillation
- Heart failure
- Ischemic stroke
- Left ventricular ejection fraction
- Humans
