Safety and Efficacy of Pulsed Field Ablation for Atrial Fibrillation in Older Patients: An Observational Study at a Large Tertiary Centre in Australia

Background: Older patients have been under-represented in clinical trials of atrial fibrillation (AF) ablation. The safety of pulsed field ablation (PFA) in this cohort is not known. Methods: We conducted an observational study of consecutive patients undergoing PFA with a pentaspline catheter (Farapulse, Boston Scientific) for AF at a tertiary centre comparing procedural and clinical outcomes in patients aged ≥ 75 years (older cohort) versus < 75 years (younger cohort). Baseline demographics, procedural characteristics, complications, and clinical outcomes were collected. Arrhythmia recurrence was defined as AF, atrial flutter, or atrial tachycardia > 30 s at any follow-up. Results: = 0.66). Conclusion: Pulsed field ablation for AF can be performed in older patients with acceptable procedural safety and clinical outcomes. Clinical trials are needed to further determine the safety and efficacy of PFA in older patients.