Long-term clinical outcome and risk of catheter ablation in elderly with non-paroxysmal atrial fibrillation.

BACKGROUND Catheter ablation of atrial fibrillation (AF) became an effective therapy for patients with drug-refractory AF and Catheter ablation of Non-Paroxysmal AF for elderly remains a challenging task. The outcome of AF ablation in Elderly is not clear. OBJECTIVE The aim of the present study was to investigate the long-term outcomes of catheter ablation in patients with non-paroxysmal AF and the predictors of AF termination, and the clinical outcomes associated with termination and non-termination. METHODS A total of 95 non-paroxysmal AF patients who received a stepwise catheter ablation were enrolled. There were 46 patients (48.4%) suffering from recurrences (37 patients with AF and 9 patients with atrial flutter/atrial tachycardia) after single procedure during a median follow-up period of 25.6 months. AF termination by ablation was achieved in 73 of the 95 patients RESULTS The AF non-termination after procedure and CHA2DS2-VASc scores ≥3 were significant predictors of recurrences in the multivariable analysis. In AF termination group: for a CHA2DS2-VASc scores of 0, 1-2, and ≥3 the recurrence rates were 29% (8/28), 39% (12/31) and 64% (9/14) respectively. Similarly, In AF non-termination group: for a CHA2DS2-VASc scores of 0, 1-2, and ≥3 the recurrence rates were 63% (5/8), 75% (6/8), and 100% (6/6), respectively. Of the patients with CHA2DS2-VASc scores of ≥3 in AF non-termination group all experienced recurrences within 2 year after the single procedure. CONCLUSIONS The catheter ablation may be effective in eliminating part of non-paroxysmal AF for elderly. In addition, the present study demonstrated that CHA2DS2-VASc scores and non-termination after procedure were useful predictors of AF recurrence.