Arrhythmias & electrophysiology
Outcomes of Atrial Fibrillation Ablation Among Older Adults in the United States: A Nationwide Study
Authors' conclusion
The use of PVI has steadily increased among older patients in contemporary U.S. clinical practice; yet, cumulative complication and hospitalization rates at 30 days have decreased over time, with stably low rates of short-term mortality despite rising comorbidity burden among treated patients.
Study context
- Population
- US Medicare fee-for-service beneficiaries aged >65 years undergoing first-time pulmonary vein isolation (PVI) for AF, 2017–202187.8% outpatient
- Participants
- 227,133 beneficiaries
- Exposure
- PVI outcomes over time
- Outcome
- Periprocedural complications, all-cause hospitalizations and mortality
- Follow-up
- 30 days
Methodological detailsnationwide, Medicare fee-for-service claims
- Nationwide
- Medicare fee-for-service claims
Main finding
As reported in the abstract
30-day outcomes, 2017 vs 2021
Complications
P < 0.001
Hospitalizations
P < 0.001
| Outcome | 2017 | 2021 |
|---|---|---|
| PVI volume | 83.8 per 100,000 patient-years | 111.6 per 100,000 patient-years |
- No significant change in mortality
- 0.4%; P = 0.08
Observational data: associations, not effects.
Safety
Most common periprocedural complications · 30 days
- Bleeding
- 1.8%
- Pericardial effusion
- 1.4%
- Vascular access damage
- 0.8%
Original publication
Outcomes of Atrial Fibrillation Ablation Among Older Adults in the United States: A Nationwide Study. JACC Clin Electrophysiol. Published 22 May 2024. doi:10.
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