Evidence map›Paper›PMID 37848806›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2024

Catheter ablation of atrial fibrillation in elderly and very elderly patients: safety, outcomes, and quality of life.

Chadi Tabaja, Arwa Younis, Pasquale Santangeli, Ruth Madden, Tyler Taigen, Medhat Farwati, Katsuhide Hayashi, Lorenzo Braghieri, John Rickard, Benjamin M Klein and 10 more

Registry-linked trialAbstract read
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In one paragraph

Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07424690 (Assessment of the Effect of Catheter Ablation on Elderly Population With Atrial Fibrillation; a Randomized Controlled Study; The ACE-AF Study), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.4field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07424690 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Assessment of the Effect of Catheter Ablation on Elderly Population With Atrial Fibrillation; a Randomized Controlled Study; The ACE-AF Study

TypeinterventionalSponsorKarolinska University HospitalRan2026 to 2034Enrolled282ConditionsAtrial Fibrillation (AF), Atrial Fibrillation Ablation, ElderlyArmsCatheter Ablation for Atrial Fibrillation, Optimized Medical Therapy for Atrial Fibrillation, Implantable Loop Recorder (ILR), AV Node Ablation With Pacemaker implantation
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Long-term outcomes of catheter ablation for atrial fibrillation in octogenarians.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025
    Observational
  3. Article
  4. Review
  5. Article
  6. Disparities in the access to atrial fibrillation ablation in Denmark: who gets ablated, who neglected?Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 1 institution in 1 country.

Chadi TabajaSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Arwa YounisSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Pasquale SantangeliSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Ruth MaddenSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Tyler TaigenSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Medhat FarwatiSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Katsuhide HayashiSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Lorenzo BraghieriSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
John RickardSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Benjamin M KleinSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Aritra PaulSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Thomas J DresingSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
David O MartinSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Mandeep BhargavaSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Mohamed KanjSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Jakub SroubekSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Hiroshi NakagawaSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Walid I SalibaSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Oussama M WazniSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA.
Ayman A HusseinSection of Cardiac Pacing and Electrophysiology, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-2, Cleveland, OH, 44195, USA. husseia@ccf.org.
Cleveland Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtrial fibrillation (AF) risk increases with age. We aim to assess the efficacy and safety of catheter ablation in the older population.

methodsAll patients undergoing AF ablation (2013-2021) at our institution were enrolled in a prospectively maintained registry. The primary endpoint was AF recurrence. Patients were divided into 3 groups: non-elderly (< 65 years), elderly (65-75 years), and very elderly (> 75 years). Patient surveys at baseline and during follow-up were used to calculate quality of life (QoL) metrics: the AF severity score as well as the AF burden.

resultsA total of 7020 patients were included (42% non-elderly, 42% elderly, and 16% very elderly). Periprocedural major complications were low (< 1.5%) and similar in all groups besides pericardial effusion which was more frequent with older age and similar between the elderly and very elderly. At 3 years, AF recurrence for persistent AF (PersAF) was highest in the very elderly group (48%), followed by the elderly group (42%), and was the lowest in the non-elderly group (36%). In paroxysmal AF (PAF), there was no difference in AF recurrence between the elderly and non-elderly, while the very elderly remained associated with a significantly increased risk. Multivariable Cox analysis confirmed these findings (PersAF; elderly: HR = 1.23, P = 0.003; very elderly: HR = 1.44, P < 0.001) (PAF; elderly: HR = 1.04, P = 0.62; very elderly: HR = 1.30, P = 0.01). Catheter ablation resulted in a significant improvement in quality of life, irrespective of age group.

conclusionCatheter ablation in elderly and very elderly patients is safe, efficacious, and associated with QoL benefits. Overall, major complications were minimal and did not differ significantly between age groups, with the exception of pericardial effusions which were higher in the elderly and very elderly compared to non-elderly adults. Very elderly patients had a higher rate of AF recurrence when compared with elderly or non-elderly patients. Nevertheless, ablation resulted in a remarkable improvement in QoL and a reduction of AF burden and AF symptoms with a similar magnitude, irrespective of age.

Indexed as

Atrial FibrillationCatheter AblationQuality of LifeRegistriesAgedAged, 80 and overAge FactorsFemaleHumansMaleMiddle AgedProspective StudiesRecurrenceTreatment OutcomeAtrial fibrillationCatheter ablationElderlyQuality of lifeRadiofrequency ablation

Identifiers

PMID37848806
OpenAlexW4387701438

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.