Temporal Trends in Atrial Fibrillation Ablation in the Elderly: Incidence of MACE and Recurrence Rates (JCEP January 2025)-Article: : Temporal Trends in Atrial Fibrillation Ablation in the Elderly: Incidence of MACE and Recurrence Rates

Article: : Temporal Trends in Atrial Fibrillation Ablation in the Elderly: Incidence of MACE and Recurrence Rates

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The study "Temporal Trends in Atrial Fibrillation Ablation in the Elderly" by Alessandra Fusco et al. investigated the increasing use of atrial fibrillation (AF) ablation among elderly patients over the period 2001 to 2020 in Denmark. The research addressed the impact of age on major adverse cardiovascular events (MACE) and post-ablation outcomes such as hospitalizations, repeat ablations, and the use of antiarrhythmic drugs (AADs).<br /><br />The study utilized nationwide Danish health care databases to track first-time AF ablations and stratified participants into three age groups: under 60, 60-74, and 75 and older, across four distinct five-year intervals. The research revealed that the number of elderly patients undergoing AF ablation increased significantly, from none in 2001 to 9% in 2020. Although elderly patients typically have a higher risk of MACE, the study observed a decrease in the 5-year MACE incidence for this group, from 61.9% to 38.1% over the study period.<br /><br />The analysis also showed a decline in the 1-year composite endpoint (AF-related hospitalizations, repeat ablation, or AAD use) over time, though age was not a consistent predictor for these outcomes. Elderly patients demonstrated a pronounced reduction in MACE events, suggesting that age should not be a barrier to considering AF ablation in suitable patients. The study underscores the potential benefits of AF ablation as a viable rhythm control strategy for elderly patients.<br /><br />The authors suggest further studies comparing AF ablation and AADs in elderly populations to provide more empirical evidence. The research benefits from Denmark's comprehensive health registries but acknowledges limitations, such as potential confounding factors and differences in definitions of long-term outcomes across studies.

Keywords

atrial fibrillation

ablation

elderly patients

cardiovascular events

antiarrhythmic drugs

Denmark

MACE

hospitalizations

rhythm control

health registries