Abstract 14224: Cryoballoon Ablation of Atrial Fibrillation in Octogenarian

Abstract

Introduction: While the safety and efficacy of AF ablation using radiofrequency (RF) have been demonstrated in the very elderly, data on the application of cryoballoon ablation in this population is limited. Hypothesis: Cryoballoon ablation of AF in the very elderly is feasible and safe. Methods: Consecutive patients who was 80 years or older and underwent de novo cryoablation of AF from June 2015 to September 2021 were included. All procedures were performed under general anesthesia and with ICE guidance. Following single transseptal puncture, a 28 Cryoballoon was used for all cases; procedural endpoint was isolation of all PVs. Extra-PV ablation including CTI, linear ablation or substrate modification was performed when deemed necessary. At the end of procedure, figure-of-8 suture was applied at the groin(s) to achieve hemostasis which was removed after 4-hour bed resting if no bleeding. Results: 70 patients were included mean age of whom was 83 (median 82, range 80-94). Baseline demographics and clinical characteristics of the patients were summarized in Table 1 . PVI was achieved in all but one patient in one PV, this vein was isolated by RF touch-up ablation. CTI ablation was performed in 26 cases but none of the patients required additional ablation. No major complication including tamponade, stroke/TIA, heart failure/fluid overload, phrenic nerve injury or death was associated to the procedure. Iliac vein bleeding developed in one case (1.43%) which required transfusion and stent placement. 11 (15.7%) patients were discharged at the same day of procedure. Overall, all patients were discharged from hospital within 25.2 hours after the procedure. Of 45 patients who completed12-month follow-up, 22 (48.9%) remained in sinus rhythm. 10 patients were reported deceased during follow-up. Conclusions: Cryoablation of AF in the very elderly is a feasible and safe procedure. Most patients can be discharged within one day or even on the same day of procedure.