Journal of the American College of Cardiology (JACC)Outcomes of AF Ablation Among Older Adults in the US

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A new study provides insights into the trends and outcomes of pulmonary vein isolation (PVI) procedures for atrial fibrillation (AF) among older adults in the United States. Analyzing data from Medicare fee-for-service beneficiaries from 2017 to 2021, the research reveals a significant increase in PVI volume, accompanied by decreasing complication and hospitalization rates. These findings offer valuable information for clinicians considering AF treatment options for older patients.

Key Points:

• PVI procedure volume increased from 83.8 to 111.6 per 100,000 patient-years between 2017 and 2021, with outpatient procedures accounting for 88% of all PVIs.
• Complication rates decreased from 3.9% in 2017 to 3.1% in 2021, while 30-day hospitalization rates dropped from 8.8% to 7.0%.
• The most common periprocedural complications were bleeding (1.8%), pericardial effusion (1.4%), and vascular access damage (0.8%).
• Mortality rates remained stable at 0.4% throughout the study period.
• The study included 227,133 patients with a mean age of 73 years, 42% female, and 93% White.
• Patients undergoing PVI showed an increasing comorbidity burden over time.
• The findings suggest that PVI is becoming increasingly common and safer for older adults with AF.

HCN Medical Memo
The rising volume of pulmonary vein isolation procedures among older adults, coupled with decreasing complication rates, suggests that this treatment option is becoming increasingly viable for managing atrial fibrillation in the elderly population. Clinicians should consider these trends when discussing treatment options with older patients.

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