VT Ablation in Geriatric Patients with Structural Heart Disease: Should there still be an Age Limit?

2021 
Introduction This study sought to examine the feasibility and outcome of ablation of ventricular tachycardias (VTs) in a contemporary cohort of geriatric patients with structural heart disease (SHD). Background Geriatric patients are often underrepresented in large studies. As frailty is becoming an increasing problem, we need to examine the best course of action for this population. Methods and results We investigated 68 SHD-patients ≥ 75 years old undergoing VT-ablation (men 88%, ischemic cardiomyopathy 77%, electrical storm 72%, mean left ventricle ejection fraction 31%) and divided the cohort in two groups: 75-79 years old (n=51) and ≥ 80 years old (n=17). The two groups showed similar results regarding non-inducibility as ablation endpoint (p = 0.693), major procedure-related complications (p = 0.488) and VT-recurrence (p = 0.882) during the 39-month follow-up. At the end of the follow up, 10 patients in the octogenarian's group (59%) vs 16 patients of the other group (31%) died. Conclusion Geriatric patients with SHD including octogenarians showed similar results regarding procedural endpoints, freedom of VT and major procedure associated complications after VT-ablation. When ablation is indicated, age alone should not be an inhibiting factor to treat these patients. This article is protected by copyright. All rights reserved.
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