Cryoballoon ablation of atrial fibrillation in octogenarians: one year outcomes from the cryo global registry

Dennis Lawin; Thorsten Lawrenz; K R Julian Chun; Hong-Euy Lim; Valentine Obidigbo; Jada M Selma; Peter Peytchev; Dinh Quang Nguyen; Csaba Földesi; Christoph Stellbrink; the Cryo AF Global Registry Investigators

doi:10.1007/s10840-023-01680-z

Cryoballoon ablation of atrial fibrillation in octogenarians: one year outcomes from the cryo global registry

J Interv Card Electrophysiol. 2023 Dec 12. doi: 10.1007/s10840-023-01680-z. Online ahead of print.

Affiliations

¹ Department of Cardiology and Intensive Care Medicine, University Hospital OWL of Bielefeld University, Campus Klinikum Bielefeld, 50 Teutoburger Street Bielefeld, 33604, Bielefeld, Germany.
² Cardioangiologisches Centrum Bethanien, Frankfurt, Germany.
³ Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
⁴ Medtronic, Inc., Minneapolis, MN, USA.
⁵ Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium.
⁶ St. Vinzenz-Hospital Köln, Cologne, Germany.
⁷ Gottsegen György Országos Kardiovaszkuláris Intézet, Budapest, Hungary.
⁸ Department of Cardiology and Intensive Care Medicine, University Hospital OWL of Bielefeld University, Campus Klinikum Bielefeld, 50 Teutoburger Street Bielefeld, 33604, Bielefeld, Germany. christoph.stellbrink@klinikumbielefeld.de.

PMID: 38082096
DOI: 10.1007/s10840-023-01680-z

Abstract

Background: Limited information is available on the safety and efficacy of cryoballoon ablation (CBA) in elderly patients with atrial fibrillation (AF). Moreover, global utilization of CBA in this population (≥ 80 years old) has not been reported. This study's objectives were to determine the use, efficacy, and safety of CBA to treat octogenarians suffering from AF.

Methods: In this sub-analysis of the Cryo Global Registry, 12-month outcomes of treating AF via CBA in octogenarians were compared to patients < 80 years old. Efficacy was evaluated as time to a ≥ 30 s atrial arrhythmia (AA) recurrence. Healthcare utilization was determined via repeat ablations and hospitalizations. Improvement upon disease burden was evaluated through patient reporting of symptoms and the EQ-5D-3L quality of life (QoL) survey.

Results: The octogenarian cohort (n = 101) had a higher prevalence of females (51.5% vs 35.7%) and CHA₂DS₂-VASc scores (4.2 ± 1.3 vs 2.0 ± 1.5) compared to the control cohort (n = 1573, both p < 0.01). Even when adjusting for baseline characteristics and antiarrhythmic drug usage, freedom from AA recurrence at 12 months (80.6% vs 78.9%, HR_adj:0.97 [95% CI:0.59-1.58], p = 0.90) was comparable between octogenarians and control, respectively. Similar serious adverse event rates were observed between octogenarians (5.0%) and control (3.2%, p = 0.38). The groups did not differ in healthcare utilization nor reduction of AF-related symptoms from baseline to follow-up, but both experienced an improvement in QoL at 12 months.

Conclusions: Despite more age-related comorbidities, CBA is a safe and effective treatment for AF in octogenarians, with efficacy and adverse events rates akin to ablations performed in younger patients.

Clinical trial registration: https://clinicaltrials.gov/ct2/show/NCT02752737.

Keywords: Atrial fibrillation; Catheter ablation; Cryoballoon; Octogenarians; Registry.

Associated data

ClinicalTrials.gov/NCT02752737