Effect of age on outcomes of catheter ablation of atrial fibrillation

Age has a great impact in the development of atrial fibrillation, which is the most common arrhythmia found in the elderly. The higher risk of stroke, heart failure and mortality associated with atrial fibrillation highlights the need for successful therapeutic interventions that can translate in better outcomes in this population. The introduction of catheter ablation has revolutionized the management of atrial fibrillation over the past decades with an undeniable impact in morbidity, mortality and quality of life. This benefit has not been fully extended to the older patients due to the lack of definitive data from randomized control trials assessing the impact of rhythm control strategies such as catheter ablation in this population, in whom a rate-control strategy has been suggested as a better therapeutic option. In this review, we summarize the pathogenesis of atrial fibrillation in the elderly, the benefits and complications of catheter ablation reported in the literature and the impact of age in the outcomes of ablation compared to younger populations.