Efficacy and safety of catheter ablation in octogenarians
Identifieur interne : 001C36 ( Main/Exploration ); précédent : 001C35; suivant : 001C37Efficacy and safety of catheter ablation in octogenarians
Auteurs : Erica S. Zado [États-Unis] ; David J. Callans [États-Unis] ; Charles D. Gottlieb [États-Unis] ; Steven P. Kutalek [États-Unis] ; Sabrina L. Wilbur [États-Unis] ; Fania L. Samuels [États-Unis] ; Scott E. Hessen [États-Unis] ; Colin M. Movsowitz [États-Unis] ; John M. Fontaine [États-Unis] ; Stephen E. Kimmel [États-Unis] ; Francis E. Marchlinski [États-Unis]Source :
- Journal of the American College of Cardiology [ 0735-1097 ] ; 1999.
English descriptors
Abstract
OBJECTIVESTo determine whether catheter ablation is safe and effective in patients over the age of 80.BACKGROUNDThere is a tendency to withhold invasive therapy in the elderly until it has been proven safe and effective.METHODSOver a two-year period from February 1, 1996 to February 1, 1998, 695 consecutive patients underwent 744 catheter ablation procedures of supraventricular and ventricular arrhythmias. These patients were divided into three groups based on age: ≥80 years, 60 to 79 years and <60 years. Acute ablation success, using standard criteria and complication rates for these three groups were determined.RESULTSThere were 37 patients ≥80 years, 275 patients 60 to 79 years and 383 patients <60 years old. The overall acute ablation success rate for the entire group was 95% with no difference in rates among the three groups (97%, ≥80 years; 94%, 60–79 years; 95%, <60 years). The percentage of patients undergoing His bundle ablation was greatest in the ≥80-year-old group (43% vs. 19% vs. 2%, p < 0.01), and the percentage of patients undergoing accessory pathway ablation was greatest in the <60-year-old patients (0% vs. 4% vs. 25%, p < 0.01). The overall complication rate for the entire group was 2.6%, and there was only one major/life-threatening complication. There was no difference in complication rates among the groups (0%, ≥80 years; 2.2%, 60 to 79 years; 3.1%, <60 years). Based on the sample size, the 95% confidence interval is 0% to 7.8% for an adverse event in the octogenarian.CONCLUSIONSCatheter ablative therapy for the arrhythmias attempted in the very elderly appears to be effective with low risk. Ablation results appear to be comparable with those noted in younger patients.
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DOI: 10.1016/S0735-1097(99)00544-6
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These patients were divided into three groups based on age: ≥80 years, 60 to 79 years and <60 years. Acute ablation success, using standard criteria and complication rates for these three groups were determined.RESULTSThere were 37 patients ≥80 years, 275 patients 60 to 79 years and 383 patients <60 years old. The overall acute ablation success rate for the entire group was 95% with no difference in rates among the three groups (97%, ≥80 years; 94%, 60–79 years; 95%, <60 years). The percentage of patients undergoing His bundle ablation was greatest in the ≥80-year-old group (43% vs. 19% vs. 2%, p < 0.01), and the percentage of patients undergoing accessory pathway ablation was greatest in the <60-year-old patients (0% vs. 4% vs. 25%, p < 0.01). The overall complication rate for the entire group was 2.6%, and there was only one major/life-threatening complication. There was no difference in complication rates among the groups (0%, ≥80 years; 2.2%, 60 to 79 years; 3.1%, <60 years). Based on the sample size, the 95% confidence interval is 0% to 7.8% for an adverse event in the octogenarian.CONCLUSIONSCatheter ablative therapy for the arrhythmias attempted in the very elderly appears to be effective with low risk. Ablation results appear to be comparable with those noted in younger patients.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Pennsylvanie</li></region></list><tree><country name="États-Unis"><noRegion><name sortKey="Zado, Erica S" sort="Zado, Erica S" uniqKey="Zado E" first="Erica S" last="Zado">Erica S. Zado</name></noRegion><name sortKey="Callans, David J" sort="Callans, David J" uniqKey="Callans D" first="David J" last="Callans">David J. Callans</name><name sortKey="Fontaine, John M" sort="Fontaine, John M" uniqKey="Fontaine J" first="John M" last="Fontaine">John M. Fontaine</name><name sortKey="Gottlieb, Charles D" sort="Gottlieb, Charles D" uniqKey="Gottlieb C" first="Charles D" last="Gottlieb">Charles D. Gottlieb</name><name sortKey="Hessen, Scott E" sort="Hessen, Scott E" uniqKey="Hessen S" first="Scott E" last="Hessen">Scott E. Hessen</name><name sortKey="Kimmel, Stephen E" sort="Kimmel, Stephen E" uniqKey="Kimmel S" first="Stephen E" last="Kimmel">Stephen E. Kimmel</name><name sortKey="Kutalek, Steven P" sort="Kutalek, Steven P" uniqKey="Kutalek S" first="Steven P" last="Kutalek">Steven P. Kutalek</name><name sortKey="Marchlinski, Francis E" sort="Marchlinski, Francis E" uniqKey="Marchlinski F" first="Francis E" last="Marchlinski">Francis E. Marchlinski</name><name sortKey="Movsowitz, Colin M" sort="Movsowitz, Colin M" uniqKey="Movsowitz C" first="Colin M" last="Movsowitz">Colin M. Movsowitz</name><name sortKey="Samuels, Fania L" sort="Samuels, Fania L" uniqKey="Samuels F" first="Fania L" last="Samuels">Fania L. Samuels</name><name sortKey="Wilbur, Sabrina L" sort="Wilbur, Sabrina L" uniqKey="Wilbur S" first="Sabrina L" last="Wilbur">Sabrina L. Wilbur</name><name sortKey="Zado, Erica S" sort="Zado, Erica S" uniqKey="Zado E" first="Erica S" last="Zado">Erica S. Zado</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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