Risk Factors Associated with Catheter Ablation in Patients with Atrial Fibrillation : A Report from the JROAD-DPC Study

Abstract

The number of patients with heart failure（HF）and atrial fibrillation（AF）is increasing as the elderly population grows. Age is a major concern and determinant of the indication for catheter ablation（CA）of AF. However, there is little safety data on CA of AF in accordance with age in Japan. We assessed the safety of CA of AF using a nationwide database〔Japanese Registry Of All cardiac and vascular Diseases（JROAD）-DPC〕. 135,299 AF patients（65±10 years, 38,952 females）who underwent CA in 456 hospitals between April 2012 and March 2018 were studied and divided into the following age groups : ＜60, 60-65, 65-70, 70-75, 75-80, 80-85, and ≥85 years. The overall in-hospital complication rate was 3.4％（cardiac tamponade 1.2％）and in-hospital mortality was 0.04％. Aged patients had a higher prevalence of female sex, lower body mass index, and a higher burden of comorbidities such as hypertension and HF, all of which were predictors for complications in multivariate analysis. A multivariate adjusted odds ratio revealed that increased age was independently and significantly associated with overall complications（60-65 years : 1.19 ; 65-70 years : 1.29 ; 70-75 years : 1.57 ; 75-80 years : 1.63 ; 80-85 years : 1.90 ; ≥85 years : 2.86 ; reference＜60 years）. In conclusion, the nationwide database of JROAD-DPC demonstrated that the frequency of complications following CA for AF increased with age.