Catheter ablation of premature ventricular contractions in elderly patients: feasibility and success.

Abstract

Catheter ablation has become a standard curative treatment for symptomatic, drug refractory premature ventricular contractions (PVC). The aim of this study was to investigate the efficacy and safety of this procedure in elderly patients. A total of 101 consecutive patients (mean age 50.7±16.9, 53% women) presenting to our center for ablation of PVC were included and assigned to two age groups (<65 and ≥65years). Clinical characteristics, procedural parameters, complications and success after 6-month follow up were compared between the two groups. Patients ≥65years (n=27) showed a higher rate of hypertension (78 vs. 27%, p<0.001), coronary artery disease (19 vs. 12%, p=0.01), renal insufficiency (22 vs. 1%, p<0.001) and diabetes (22 vs. 3%, p=0.001). Left ventricular ejection fraction did not differ between the two groups (56.6 vs. 57.4%, p=0.497). In patients <65years the origin of the PVC was significantly more often in RVOT or LVOT (95 vs. 70%, p=0.001). Acute success rates (67 vs. 73%, p=0.545) and success rates after 6months (81 vs. 86%, p=0.795) were not different between the two groups. Two complications were observed, both occurred in the <65years group (1 pericardial effusion and 1 large groin hematoma). Catheter ablation of PVC is feasible in elderly patients without overt heart disease. Success rates are not significantly different compared to patients <65years. Procedural complications are rare in both the groups. Ablation of this arrhythmia can therefore be regarded as a promising curative treatment in advanced age.