Data_Sheet_1_Efficacy and Safety of Ablation for Symptomatic Atrial Fibrillation in Elderly Patients: A Meta-Analysis.PDF

Background: Age affects the efficacy of pharmacological treatment for atrial fibrillation (AF). Catheter ablation, including radiofrequency (RF) or cryoballoon ablation, is an effective strategy for symptomatic AF. This meta-analysis aimed to analyze the efficacy and safety of AF ablation in elderly patients with AF compared to non-elderly patients with AF.
Methods: We searched several databases for articles published between January 1, 2008 and March 31, 2020. Eighteen observational studies with 21,039 patients were analyzed. Data including recurrence of AF or atrial tachyarrhythmia (ATA), complications, procedural time, and fluoroscopic time were compared between the elderly and non-elderly groups.
Results: The elderly patients had significantly higher incidences of recurrent AF or ATA after AF ablation compared to the non-elderly patients (<60 years old) (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.11–1.33). The elderly patients had significantly higher incidences of complications of AF ablation compared to the non-elderly patients (OR, 1.37; 95% CI, 1.14–1.64). However, elderly AF patients with age ≥75 years old had similar incidence of recurrent AF or ATA and complication after AF ablation compared to non-elderly patients with AF.
Conclusions: The elderly patients had significantly higher incidences of recurrent AF or ATA and complications after ablation for non-paroxysmal AF compared to non-elderly patients with AF (<60 years old), except in patients ≥75 years old.

背景：年龄会影响心房颤动（Atrial Fibrillation, AF）的药物治疗疗效。导管消融术，包括射频（radiofrequency, RF）消融与冷冻球囊消融，是治疗症状性心房颤动的有效策略。本荟萃分析旨在对比老年心房颤动患者与非老年心房颤动患者接受AF消融术的疗效与安全性。
方法：我们检索了2008年1月1日至2020年3月31日期间发表于多个数据库的文献。最终纳入18项观察性研究，共涉及21039名患者进行分析。对比老年组与非老年组的多项数据，包括AF或心房快速性心律失常（atrial tachyarrhythmia, ATA）复发率、手术并发症、操作时长及透视时长。
结果：与<60岁的非老年患者相比，老年心房颤动患者在接受AF消融术后，AF或ATA复发率显著更高（比值比[odds ratio, OR]=1.21；95%置信区间[95% confidence interval, CI]：1.11~1.33）。同时，老年患者的AF消融术并发症发生率也显著高于非老年患者（OR=1.37；95%CI：1.14~1.64）。但年龄≥75岁的老年心房颤动患者，其AF或ATA复发率与术后并发症发生率与非老年患者无显著差异。
结论：与<60岁的非老年心房颤动患者相比，非阵发性心房颤动患者接受消融术后，老年群体的AF或ATA复发率与手术并发症发生率均显著更高，但年龄≥75岁的患者除外。