Anticoagulant therapy and risk of cerebrovascular events after catheter ablation of atrial fibrillation in the elderly.

Stroke and Atrial Fibrillation Ablation. Introduction: Factors associated with cerebrovascular events (CVEs) after radiofrequency catheter ablation (RFA) of atrial fibrillation (AF) have not been well defined in elderly patients (≥65 years). The purpose of this study was to determine the prevalence and predictors of CVEs after RFA in patients with AF ≥65 years old, in comparison to patients <65 years, and with or without AF. Methods and Results: This study included 508 consecutive patients ≥65 years old (mean age: 70 ± 4 years), who underwent RFA for paroxysmal (297) or persistent (211) AF. A stratified group of 508 patients 4 weeks after the RFA) occurred in 15 of 508 (3%) of patients ≥65 years old (1% per year) and in 5 of 508 (1%) patients 75 years old (OR = 4.9, ±95% CI: 3.3–148.5, P = 0.001) was the only independent predictor of a CVE. Among patients <65 years old, body mass index was the only independent predictor of a late CVE (OR = 1.2, ±95% CI: 1.03–1.33, P = 0.02). Conclusions: The risk of a periprocedural CVE after RFA of AF is similar among patients ≥65 and 75 years old is the only independent predictor of late CVEs regardless of the rhythm, anticoagulation status, or the CHADS2 score (Congestive heart failure, Hypertension, Age ≥ 75 years, Diabetes mellitus and prior Stroke or transient ischemic attack). (J Cardiovasc Electrophysiol, Vol. 23, pp. 36-43, January 2012)