Abstract 4113854: Outcomes Of Atrial Fibrillation Ablation In Elderly: A Retrospective Cohort Study

Introduction: Atrial fibrillation (Afib) is a common cardiac arrhythmia that increases in prevalence with age. Ablation has been widely used for managing Afib, but its outcomes in octogenarians have been less thoroughly investigated. Research Question: This study aims to assess the in-hospital outcomes of Afib ablation in patients aged above 80 compared to those below 80 years old. Methods: Data was obtained from the Nationwide Inpatient Sample database from January 2016 to December 2020. The study included all adult patients with a primary discharge diagnosis of Afib who underwent catheter ablation during their hospitalization. These patients were then categorized into two groups based on age: below 80 and above 80 years. In-hospital outcomes for these groups were then looked at. The primary outcome was inpatient mortality. Secondary outcomes were the length of stay, cost of hospitalization, cardiac arrest, cardiac tamponade, arrhythmias, acute respiratory failure, acute renal failure, procedural complications as well as the need for dialysis, transfusions, pressors, ventilators, and tracheostomy. Results: Out of about 35 million admissions screened, 403,247 patients had Afib as their primary discharge diagnosis, of these, 17,927 patients underwent catheter ablations during their hospitalization. Amongst them, 3,051(17%) were above the age of 80 years. The in-hospital mortality was slightly higher in the elderly compared to the younger cohort (1.1% vs 0.5%, aOR: 1.87; 95% CI: 1.20-2.92, p=0.006). They had a longer hospital stay (5.14 days vs. 3.72 days, p<0.001) and lower hospitalization costs (USD 138,091 vs. USD 162,788, p<0.001). Complications such as acute respiratory failure and acute renal failure were more frequent in the older age group, while no significant differences were observed in cardiac arrest, cardiac tamponade, ventricular arrhythmias, and most device-related complications. The need for new dialysis, mechanical ventilation, and pressor use was significantly less in the above-80 group. Conclusion: Afib ablation in older adults, results in slightly higher in-hospital mortality and longer hospital stays compared to younger patients. Despite these differences, the overall complication rates are comparable, suggesting that age alone should not deter the selection of patients for Afib ablation. Further studies are needed to validate these findings and optimize management strategies for the elderly population.