Impact of age on the management and prognosis of esophageal fistula after atrial fibrillation ablation-a subanalysis of the worldwide POTTER-AF study.
Esophageal fistula (EF) is a rare but devastating complication following atrial fibrillation (AF) ablation. Data regarding the impact of age on EF are scarce.
To study the impact of age on the management and prognosis of EF following catheter ablation for AF.
The POTTER-AF study is a worldwide registry on EF following catheter ablation for AF. A total of 553,729 patients underwent AF ablation in 214 centers between 1996 and 2022. Of them, 138 patients experienced EF, and data regarding age, management, and prognosis were available in 113 patients. The population was divided based on the median age.
The median age was 63 years; 54 patients were <63 years old (Group 1), and 59 patients were ≥63 years old (Group 2). The groups were similar regarding procedural characteristics. The older population had a shorter time to symptom onset [15.0 (6.0, 21.0) vs. 21.0 (10.0, 25.3) days; p = 0.031]. Group 2 was less likely to receive a brain CT or MRI for diagnosis (25.9% vs. 45.3%; p = 0.046). The older population was more likely to undergo endoscopic treatment without surgery (27.6% vs. 11.3%; p = 0.035). Conservative and surgical treatments were used in similar proportions. A trend toward higher fatality was noted in the older patients (72.9% vs. 56.6%; p = 0.078).
The older population had a shorter time to symptom onset, was less likely to receive a brain CT or MRI, and more likely to be treated by an endoscopic approach only. The older patient group showed a trend toward a higher fatality.
To study the impact of age on the management and prognosis of EF following catheter ablation for AF.
The POTTER-AF study is a worldwide registry on EF following catheter ablation for AF. A total of 553,729 patients underwent AF ablation in 214 centers between 1996 and 2022. Of them, 138 patients experienced EF, and data regarding age, management, and prognosis were available in 113 patients. The population was divided based on the median age.
The median age was 63 years; 54 patients were <63 years old (Group 1), and 59 patients were ≥63 years old (Group 2). The groups were similar regarding procedural characteristics. The older population had a shorter time to symptom onset [15.0 (6.0, 21.0) vs. 21.0 (10.0, 25.3) days; p = 0.031]. Group 2 was less likely to receive a brain CT or MRI for diagnosis (25.9% vs. 45.3%; p = 0.046). The older population was more likely to undergo endoscopic treatment without surgery (27.6% vs. 11.3%; p = 0.035). Conservative and surgical treatments were used in similar proportions. A trend toward higher fatality was noted in the older patients (72.9% vs. 56.6%; p = 0.078).
The older population had a shorter time to symptom onset, was less likely to receive a brain CT or MRI, and more likely to be treated by an endoscopic approach only. The older patient group showed a trend toward a higher fatality.
Authors
Popescu Popescu, Demirtakan Demirtakan, Schmidt Schmidt, Pürerfellner Pürerfellner, Sommer Sommer, Sohns Sohns, Veltmann Veltmann, Steven Steven, Chun Chun, Maury Maury, Gandjbakhch Gandjbakhch, Laredo Laredo, Willems Willems, Beiert Beiert, Iden Iden, Füting Füting, Spittler Spittler, Richter Richter, Schade Schade, Kuniss Kuniss, Wunderlich Wunderlich, Shin Shin, Grosse Meininghaus Grosse Meininghaus, Bonsels Bonsels, Reek Reek, Wiegand Wiegand, Bauer Bauer, Metzner Metzner, Eckardt Eckardt, Krahnefeld Krahnefeld, Sticherling Sticherling, Kühne Kühne, Nguyen Nguyen, Roten Roten, Linz Linz, van der Voort van der Voort, Mulder Mulder, Vijgen Vijgen, Almorad Almorad, Guenancia Guenancia, Fauchier Fauchier, Boveda Boveda, De Greef De Greef, Da Costa Da Costa, Jais Jais, Milhem Milhem, Jesel Jesel, Garcia Garcia, Poty Poty, Khoueiry Khoueiry, Seitz Seitz, Laborderie Laborderie, Mechulan Mechulan, Brigadeau Brigadeau, Zhao Zhao, Saludas Saludas, Piot Piot, Ahluwalia Ahluwalia, Martin Martin, Chen Chen, Antolic Antolic, Leventopoulos Leventopoulos, Özcan Özcan, Yorgun Yorgun, Cay Cay, Yalin Yalin, Sobhy Botros Sobhy Botros, Jędrzejczyk-Patej Jędrzejczyk-Patej, Inaba Inaba, Okumura Okumura, Ejima Ejima, Khakpour Khakpour, Catanzaro Catanzaro, Reddy Reddy, Natale Natale, Blessberger Blessberger, Yang Yang, Vogler Vogler, Kuck Kuck, Merino Merino, Keelani Keelani, Heeger Heeger, Tilz Tilz
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