Efficacy and safety of intracardiac echocardiography-guided “one-stop” procedures combining radiofrequency catheter ablation and left atrial appendage closure in elderly patients with atrial fibrillation
10.3760/cma.j.cn112148-20240706-00372
- VernacularTitle:老年心房颤动患者行心腔内超声指导下射频消融联合经皮左心耳封堵“一站式”手术的疗效及安全性分析
- Author:
Xining SHANG
1
;
Mingyu SUN
1
;
Zulu WANG
1
;
Zhiqing JIN
1
;
Ming LIANG
1
;
Jian DING
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;
Radiofrequency catheter ablation;
Left atrial appendage closure;
Intracardiac echocardiography;
Elderly;
“One-stop” procedure
- From:
Chinese Journal of Cardiology
2025;53(1):49-55
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the efficacy and safety of “one-stop” procedures combining radiofrequency catheter ablation and left atrial appendage closure by guidance of intracardiac echocardiography(ICE) in elderly patients with atrial fibrillation.Methods:A retrospective cohort study was conducted on patients who underwent ICE-guided “one-stop” procedures at the Department of Cardiology, General Hospital of Northern Theater Command between December 2020 and January 2023. Patients were divided into elderly group (age≥60 years old) and non-elderly group (age 18-59 years old). The clinical characteristics, acute success rate, peri-operative complications and follow-up data between two groups were compared. Multivariate logistic regression analysis was used to analyze whether age was the influencing factor for perioperative complications and atrial fibrillation recurrence.Results:A total of 213 atrial fibrillation patients were enrolled, including 158 (74.18%) in the elderly group (age: (68.3±5.0) years; 56.96% male) and 55 (25.82%) in the non-elderly group (age: (53.7±5.2) years; 81.82% male). The elderly group had lower proportions of males, persistent atrial fibrillation, and left atrial spontaneous echocardiographic contrast compared to the non-elderly group ( P<0.05). CHA 2DS 2-VASc and HAS-BLED scores were higher in elderly group ( P<0.05). The acute success rate,“one-stop” procedure time, fluoroscopy time and the rate of peri-operative complications (6 (3.80%) in elderly group vs. 2 (3.64%) in non-elderly group) were similar between two groups (all P>0.05). The average time of clinical and telephone interviews in elderly group and non-elderly group was (16.9±6.1) months and (17.9±5.9) months, respectively. There was no significant difference in the rate of atrial fibrillation recurrence or clinical events between two groups (47 (30.72%) vs. 14 (26.42%), P=0.554; 10 (6.54%) vs. 2(3.77%), P=0.689, respectively). Iatrogenic atrial septal defects in 3-month transesophageal echocardiography follow up were detected in 44 patients (36.97%) in elderly group and 9 patients (19.57%) in non-elderly group ( P=0.032). Multivariate logistic regression analysis results showed that age was not the influencing factor for peri-operative complications and atrial fibrillation recurrence ( P=0.905 and P=0.676, respectively). Conclusion:Intracardiac echocardiography-guided “one-stop” procedures in the treatment of atrial fibrillation in elderly patients are safe and effective.
