Catheter ablation in atrial fibrillation: a valid therapeutic option also for older patients?

Abstract

Atrial fibrillation (AF) represents the arrhythmic epidemics of the 21st century. It is not only the most common cardiac arrhythmia encountered in daily clinical practice, but it is associated as well with high cardiac morbidity and mortality. Its incidence increases exponentially with aging, with about 10% of the population over 80 years old being affected. Pharmacological treatment of AF in the elderly deals with several issues related to differences in the mechanisms underlying this arrhythmia and pharmacokinetics, and to the anatomical and electrical remodeling associated with aging. Catheter ablation of AF might represent a good therapeutic option in this patient population, since it is conceived to cure patients from this arrhythmia and it is not associated with the common side effects of antiarrhythmic drugs. The aim of this brief review is to summarize the available evidence on the safety and efficacy of catheter ablation of AF in geriatric age, trying to balance the natural enthusiasm of cardiac electrophysiologists with some expected skepticism of geriatricians.