Volume 12, Issue 1, Pages (January 2015)

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Date of download: 7/10/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Choice of Antithrombotic Therapy for Stroke Prevention.

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Volume 12, Issue 1, Pages 44-51 (January 2015) Benefits and risks of catheter ablation in elderly patients with atrial fibrillation Koonlawee Nademanee, MD, FHRS, Montawatt Amnueypol, MD, Frances Lee, RN, Carla M. Drew, BS, Wanwimol Suwannasri, BSc (Pharm), Mark C. Schwab, MD, Gumpanart Veerakul, MD Heart Rhythm Volume 12, Issue 1, Pages 44-51 (January 2015) DOI: 10.1016/j.hrthm.2014.09.049 Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 1 Comparison of 4-year atrial tachycardia/atrial fibrillation (AT/AF) burden between group 1 and group 2 patients with an implantable device. Each circle represents AT/AF burden of individual patients at a given time point. Red indicates group 1; green indicates group 2. Heart Rhythm 2015 12, 44-51DOI: (10.1016/j.hrthm.2014.09.049) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 2 Kaplan–Meier curve demonstrating improved survival in patients who remained in sinus rhythm after atrial fibrillation (AF) ablation from all-cause mortality compared to patients who remained in AF fibrillation after ablation and patients who did not undergo catheter ablation. Heart Rhythm 2015 12, 44-51DOI: (10.1016/j.hrthm.2014.09.049) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 3 Stroke/bleeding incidence of both group 1 and 2 patients according to their final rhythms and CHADS2 scores. AF = atrial fibrillation; AT = atrial tachycardia; IH = intracranial hemorrhage; IS = ischemic stroke; NSR = normal sinus rhythm; SH = subdural hematoma; TIA = transient ischemic attack. Heart Rhythm 2015 12, 44-51DOI: (10.1016/j.hrthm.2014.09.049) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 4 Multiple overlay Kaplan–Meier stroke/bleeding–free survival curves among 5 groups of patients: (1) successful ablation–normal sinus rhythm (NSR) on no warfarin, (2) successful ablation–NSR on warfarin, (3) unsuccessful ablation–atrial fibrillation (AF) on no warfarin, (4) unsuccessful ablation–AF on warfarin, and (5) no ablation–NSR on warfarin (group 2). Heart Rhythm 2015 12, 44-51DOI: (10.1016/j.hrthm.2014.09.049) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 1 The figure shows the AT/AF response I effect of AF ablation, as shown in the electroanatomical map in the upper right corner, on AT/AF burden in an 80-year-old female with long-standing persistent AF. The patient had a 0% AT/AF burden for over 3 years, then in September 2011, had intermittent brief episodes of atrial tachyarrhythmias, but the total burden was <0.1%. Heart Rhythm 2015 12, 44-51DOI: (10.1016/j.hrthm.2014.09.049) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 2 The figure (AT/AF response II) shows an AT/AF burden of a 78-year-old female with long-standing persistent AF and the electroanatomical map showing ablation areas. After ablation, the patient continued to have paroxysmal episodes of atrial tachyarrhythmias, but the AT/AF burden ranged from 1-2.8%; however, no single episode was longer than 12 hours. Heart Rhythm 2015 12, 44-51DOI: (10.1016/j.hrthm.2014.09.049) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 3 The figure (AT/AF response III) shows a drastic reduction in AT/AF burden of an 81-year-old male with persistent AF, but continued to have recurrent atrial flutter episodes that lasted longer than 12 hours. The patient subsequently underwent a successful left atrial flutter ablation in March 2008, resulting in elimination of recurrent AT/AF episodes, and had an AT/AF response I with burden <0.1%. Heart Rhythm 2015 12, 44-51DOI: (10.1016/j.hrthm.2014.09.049) Copyright © 2015 Heart Rhythm Society Terms and Conditions