Does Age Impact Safety and Efficacy During Pulse‐Field Ablation for Atrial Fibrillation?
Background There is no evidence evaluating efficiency, effectiveness, and safety outcomes in older patients in the context of pulsed‐field ablation technology for the ablation of atrial fibrillation. We aimed to compare safety, efficacy, and acute and long‐term outcomes of pulsed‐field ablation in o...
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2025-05-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.037959 |
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| author | Antonio Dello Russo Claudio Tondo Stefano Bianchi Vincenzo Schillaci Saverio Iacopino Michela Casella Antonio Rossillo Ruggero Maggio Sakis Themistoclakis Matteo Bertini Maurizio Russo Mario Volpicelli Graziana Viola Roberto Rordorf Marco Schiavone Yari Valeri Jacopo Colella Pietro Rossi Fabrizio Tundo Gianluca Zingarini Antonio De Simone Lorenzo Bianchini Alessandro Di Vilio Paolo Compagnucci Maurizio Malacrida Giulio Zucchelli Francesco Solimene |
| author_facet | Antonio Dello Russo Claudio Tondo Stefano Bianchi Vincenzo Schillaci Saverio Iacopino Michela Casella Antonio Rossillo Ruggero Maggio Sakis Themistoclakis Matteo Bertini Maurizio Russo Mario Volpicelli Graziana Viola Roberto Rordorf Marco Schiavone Yari Valeri Jacopo Colella Pietro Rossi Fabrizio Tundo Gianluca Zingarini Antonio De Simone Lorenzo Bianchini Alessandro Di Vilio Paolo Compagnucci Maurizio Malacrida Giulio Zucchelli Francesco Solimene |
| author_sort | Antonio Dello Russo |
| collection | DOAJ |
| description | Background There is no evidence evaluating efficiency, effectiveness, and safety outcomes in older patients in the context of pulsed‐field ablation technology for the ablation of atrial fibrillation. We aimed to compare safety, efficacy, and acute and long‐term outcomes of pulsed‐field ablation in older patients (≥75 years) with younger ones. Methods We enrolled consecutive patients who had undergone atrial fibrillation ablation with the pulsed‐field ablation FARAPULSE system (Boston Scientific) at 15 centers. Patients were stratified by age (<65, 65–74, and ≥75 years) and efficacy and safety profiles of these groups were compared. Results A total of 1082 patients were included: 108 (10%) were ≥75 years old, 374 (34.6%) were 65–74 years old and 600 (55.4%) were <65 years old. Older patients displayed a more pronounced risk profile compared with their younger counterparts, characterized by a significant higher burden of comorbidities. No differences in terms of procedural metrics were found. Pulmonary vein isolation was achieved in all patients. An overall low rate of procedural‐related complications was reported (3.0%) without difference between young and older patients (P=0.241). During a mean follow‐up of 342±111 days, a primary efficacy end point occurred in 605 of 748 (80.9%) patients with available outcome information. The arrhythmia recurrence rate ranged from 14.4% in patients <65 years old to 26.9% of older patients (P=0.011). Conclusions Drawing from these findings, using the FARAPULSE system for atrial fibrillation ablation in older patients demonstrated swift, safe, and effective acute outcomes, mirroring a comparable pattern observed in younger patients and recurrence rates in line with the literature in older patients. Registration URL: clinicaltrials.gov; Unique Identifier: NCT05617456. |
| format | Article |
| id | doaj-art-2c66579c6edc496bb81d689cd1c99354 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-2c66579c6edc496bb81d689cd1c993542025-08-20T01:52:19ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-05-0114910.1161/JAHA.124.037959Does Age Impact Safety and Efficacy During Pulse‐Field Ablation for Atrial Fibrillation?Antonio Dello Russo0Claudio Tondo1Stefano Bianchi2Vincenzo Schillaci3Saverio Iacopino4Michela Casella5Antonio Rossillo6Ruggero Maggio7Sakis Themistoclakis8Matteo Bertini9Maurizio Russo10Mario Volpicelli11Graziana Viola12Roberto Rordorf13Marco Schiavone14Yari Valeri15Jacopo Colella16Pietro Rossi17Fabrizio Tundo18Gianluca Zingarini19Antonio De Simone20Lorenzo Bianchini21Alessandro Di Vilio22Paolo Compagnucci23Maurizio Malacrida24Giulio Zucchelli25Francesco Solimene26Department of Biomedical Sciences and Public Health Marche Polytechnic University Ancona ItalyMonzino Cardiological Center Milan ItalyCenter of Excellence in Cardiovascular Sciences Ospedale Isola Tiberina ‐ Gemelli Isola Rome ItalyMontevergine Clinic Mercogliano AV ItalyMaria Cecilia Hospital, GVM Care & Research Cotignola RA ItalyDepartment of Cardiology and Arrhythmology Clinic Marche University Hospital Ancona ItalySan Bortolo Hospital Vicenza ItalyDegli Infermi Hospital Rivoli TO ItalyDell’Angelo Hospital Mestre VE ItalyCardiology Unit, University of Ferrara Sant’Anna University Hospital Ferrara ItalySan Filippo Neri Hospital Rome ItalyCardiovascular Diseases and Electrophysiology Unit S. Maria della Pietà Hospital Nola, Naples ItalyClinical and Experimental Cardiology, Clinical and Interventional Cardiology University Hospital Sassari ItalyArrhythmia and Electrophysiology Unit, Division of Cardiology Fondazione IRCCS Policlinico San Matteo Pavia ItalyMonzino Cardiological Center Milan ItalyDepartment of Cardiology and Arrhythmology Clinic Marche University Hospital Ancona ItalyMaria Cecilia Hospital, GVM Care & Research Cotignola RA ItalyCenter of Excellence in Cardiovascular Sciences Ospedale Isola Tiberina ‐ Gemelli Isola Rome ItalyMonzino Cardiological Center Milan ItalyS. Maria della Misericordia Hospital Perugia ItalyS. Michele Clinic Maddaloni CE ItalyMonzino Cardiological Center Milan ItalyMaria Cecilia Hospital, GVM Care & Research Cotignola RA ItalyDepartment of Biomedical Sciences and Public Health Marche Polytechnic University Ancona ItalyBoston Scientific Milan ItalySecond Division of Cardiology, Cardiac‐Thoracic‐Vascular Department New Santa Chiara Hospital, Azienda Ospedaliero Universitaria Pisana Pisa ItalyDepartment of Biomedical Sciences and Public Health Marche Polytechnic University Ancona ItalyBackground There is no evidence evaluating efficiency, effectiveness, and safety outcomes in older patients in the context of pulsed‐field ablation technology for the ablation of atrial fibrillation. We aimed to compare safety, efficacy, and acute and long‐term outcomes of pulsed‐field ablation in older patients (≥75 years) with younger ones. Methods We enrolled consecutive patients who had undergone atrial fibrillation ablation with the pulsed‐field ablation FARAPULSE system (Boston Scientific) at 15 centers. Patients were stratified by age (<65, 65–74, and ≥75 years) and efficacy and safety profiles of these groups were compared. Results A total of 1082 patients were included: 108 (10%) were ≥75 years old, 374 (34.6%) were 65–74 years old and 600 (55.4%) were <65 years old. Older patients displayed a more pronounced risk profile compared with their younger counterparts, characterized by a significant higher burden of comorbidities. No differences in terms of procedural metrics were found. Pulmonary vein isolation was achieved in all patients. An overall low rate of procedural‐related complications was reported (3.0%) without difference between young and older patients (P=0.241). During a mean follow‐up of 342±111 days, a primary efficacy end point occurred in 605 of 748 (80.9%) patients with available outcome information. The arrhythmia recurrence rate ranged from 14.4% in patients <65 years old to 26.9% of older patients (P=0.011). Conclusions Drawing from these findings, using the FARAPULSE system for atrial fibrillation ablation in older patients demonstrated swift, safe, and effective acute outcomes, mirroring a comparable pattern observed in younger patients and recurrence rates in line with the literature in older patients. Registration URL: clinicaltrials.gov; Unique Identifier: NCT05617456.https://www.ahajournals.org/doi/10.1161/JAHA.124.037959ageatrial fibrillationelectroporationolder patientspulsed‐field ablation |
| spellingShingle | Antonio Dello Russo Claudio Tondo Stefano Bianchi Vincenzo Schillaci Saverio Iacopino Michela Casella Antonio Rossillo Ruggero Maggio Sakis Themistoclakis Matteo Bertini Maurizio Russo Mario Volpicelli Graziana Viola Roberto Rordorf Marco Schiavone Yari Valeri Jacopo Colella Pietro Rossi Fabrizio Tundo Gianluca Zingarini Antonio De Simone Lorenzo Bianchini Alessandro Di Vilio Paolo Compagnucci Maurizio Malacrida Giulio Zucchelli Francesco Solimene Does Age Impact Safety and Efficacy During Pulse‐Field Ablation for Atrial Fibrillation? Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease age atrial fibrillation electroporation older patients pulsed‐field ablation |
| title | Does Age Impact Safety and Efficacy During Pulse‐Field Ablation for Atrial Fibrillation? |
| title_full | Does Age Impact Safety and Efficacy During Pulse‐Field Ablation for Atrial Fibrillation? |
| title_fullStr | Does Age Impact Safety and Efficacy During Pulse‐Field Ablation for Atrial Fibrillation? |
| title_full_unstemmed | Does Age Impact Safety and Efficacy During Pulse‐Field Ablation for Atrial Fibrillation? |
| title_short | Does Age Impact Safety and Efficacy During Pulse‐Field Ablation for Atrial Fibrillation? |
| title_sort | does age impact safety and efficacy during pulse field ablation for atrial fibrillation |
| topic | age atrial fibrillation electroporation older patients pulsed‐field ablation |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.037959 |
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