# Periprocedural Safety of Interventional Electrophysiological Procedures in Octogenarians and Nonagenarians

## TL;DR

This study examines the safety of heart procedures in elderly patients and finds a higher risk of complications compared to younger individuals.

## Contribution

The study provides new insights into the periprocedural safety of EP procedures in octogenarians and nonagenarians.

## Key findings

- Aged patients had a significantly higher rate of minor complications compared to younger controls.
- There was a trend toward more major complications and intrahospital deaths in elderly patients.
- Invasive EP procedures in the elderly are feasible but carry higher risks.

## Abstract

Catheter ablation is an established treatment for cardiac arrhythmia. There is a lack of data on invasive electrophysiological (EP) procedures in aged patients.

Consecutive patients ≥ 80 years who underwent catheter ablation or left atrial appendage closure procedures between January 2005 and December 2017 in a high‐volume center were retrospectively studied and compared to a matched control group of individuals < 80 years of age.

The aged group consisted of 486 patients who underwent 566 procedures at a mean age of 82.7 ± 2.5 years (range 80−95 years). A cohort of 480 patients aged < 80 years (mean age 64.1 ± 13.3 years) with 566 procedures served as a control group. Performed procedures were atrial arrhythmia ablation including atrial fibrillation treatment (n = 366, 64.7%), cavotricuspid isthmus ablation (n = 139, 24.6%), ablation of ventricular arrhythmias (n = 57, 10.1%), and left atrial appendage closure (n = 12, 2.1%). There were numerically more procedures with major complications after treatment of elderly patients (32 [5.7%] vs. 21 [3.5%] procedures, p = 0.12), as well as numerically more procedures accompanied by intrahospital deaths (6 [1.1%] vs. 1 [0.2%] procedure, p = 0.12). The rate of minor complications was significantly higher in aged patients as compared to younger controls (31 [5.1%] vs. 17 [20%] procedures, p = 0.039).

Invasive EP procedures in octogenarians and nonagenarians are feasible, however a significantly higher incidence of minor periprocedural complications and a trend toward more severe complications and intrahospital fatalities were observed compared to younger patients. These findings support an individual risk‐benefit assessment for elderly individuals before invasive EP treatments are conducted.

Analysis of invasive electrophysiological procedures in aged patients and a control group of younger individuals.