Safety and long-term efficacy of ablation index-guided radiofrequency catheter ablation and second-generation cryoballoon ablation in elderly patients with atrial fibrillation
10.3760/cma.j.cn112148-20250207-00088
- VernacularTitle:老年房颤患者消融指数指导下射频导管消融与二代冷冻球囊消融的安全性及长期疗效
- Author:
Xuan WANG
1
;
Mingyu SUN
1
;
Zulu WANG
1
;
Ming LIANG
1
;
Zhiqing JIN
1
;
Jian DING
1
;
Ping ZHANG
1
;
Yaling HAN
1
Author Information
1. 解放军北部战区总医院心血管内科 寒地心血管病全国重点实验室，沈阳 110016
- Publication Type:Journal Article
- Keywords:
Atrial fibrillation;
Catheter ablation;
Radiofrequency catheter ablation;
Second-generation cryoballoon ablation;
Elderly patients
- From:
Chinese Journal of Cardiology
2025;53(4):382-387
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of ablation index-guided radiofrequency catheter ablation (RFCA) and second-generation cryoballoon ablation (CBA) in elderly patients with atrial fibrillation (AF).Methods:This retrospective cohort study included 1 986 patients undergoing pulmonary vein isolation for AF at General Hospital of Northern Theater Command from August 2016 to May 2020, comprising 760 RFCA cases and 1 226 CBA cases. Elderly patients were defined as those aged 60 years or older, while non-elderly patients were those under 60 years of age. All patients were followed up for 3 years after the procedure to assess AF recurrence rates. Kaplan-Meier survival curves were plotted and compared by log-rank test. Multivariate logistic regression was used to analyze the influencing factors of AF recurrence.Results:Among 1 986 AF patients (aged (58.7±10.2) years; 1 307 males, 65.81%; 987 elderly patients, 49.70%), the overall AF recurrence rate was 24.37% (484/1 986). Kaplan-Meier analysis demonstrated a higher AF recurrence rate in the elderly group compared to the non-elderly group (log-rank P=0.007). In the RFCA group, AF recurrence rate was 22.50% (171/760), with no significant difference between the elderly (24.44%, 88/360) and non-elderly (20.75%, 83/400) subgroups ( P=0.223). In the CBA group, recurrence rates were 25.53% (313/1 226), with significantly higher recurrence in elderly patients (28.55%, 179/627) than non-elderly (22.37%, 134/599) ( P=0.013). Multivariate logistic regression analysis revealed that advanced age was not an independent predictor of AF recurrence ( P=0.447). Longer AF duration and larger left atrial diameter were independent risk factors for recurrence, while male sex was a protective factor (all P<0.05). Conclusion:Pulmonary vein isolation with second-generation CBA and RFCA guided by ablation index are safe and effective in the treatment of AF in elderly patients.
