Abstract 179: Impact Of Age On Catheter Ablation For Atrial Fibrillation In Octogenarians

Abstract

Introduction: Patients undergoing catheter ablation for atrial fibrillation (CA-AF) often have significant co-morbidities. Although multiple comorbidities increase with age, outcomes of CA-AF), particularly, in older patients has been conflicting. Methods: The International Classification of Diseases Code, 10 th Revision Clinical Modification (ICD-10) was used to identify patients hospitalized for CA-AF between 2016-2019 from the National Readmission database (NRD). Patients were classified into two groups, those younger than 80 years and older than 80 years. Ninety-day readmission rates and causes of readmission were compared. Adjusted multivariate regression analysis was used to identify factors associated with readmissions. Results: We identified 40,174 patients who underwent CA-AF from this cohort, 5875 (14.6%) patients were above the age of 80 years and these patients were more likely to have congestive heart failure (72.8% vs 42.6 %), valvular disease (39.3% vs 20.4), pulmonary vascular disorders (18.5% vs 7.4%), chronic pulmonary disease (29.9% vs 23%) and renal failure (35.7% vs 16.6%). In addition, patients >80 years had longer hospital length of stay, higher rates of major adverse cardiovascular events (6.4% vs 3.5%; p<0.0001), acute heart failure and sepsis during their index admission when compared with patients < 80 years. A total of 1201 (20.4%) patients above age for 80 years were readmitted within 90 days as compared to 4295 (12.5%) below the age of 80 years ( p<0.001). Acute heart failure, AF and acute kidney injury were the most common causes for readmission. The following factors were associated with higher risk of readmission in multivariate regression analysis: length of stay > 4 days (OR 1.36 95% CI 1.17-1.91, P<0.0001), chronic pulmonary disease (OR 1.35 95%1.17-1.55, P<0.0001) and renal failure (OR 1.25 95% CI 1.006-1.55, p=0.04). Conclusion: Age > 80 years is associated with increased risk of complications and higher readmission post CA-AF in patients with OSA . Shared medical decision making for octogenarians with AF should consider these data and alternative treatment strategies when appropriate.