Characteristics and anticoagulant treatment status of elderly non-valvular atrial fibrillation patients with a history of catheter ablation in Japan: Subanalysis of the ANAFIE registry. Issue 5 (November 2020)

• Record Type: Journal Article
• Authors: Okumura, Ken; Yamashita, Takeshi; Akao, Masaharu; Atarashi, Hirotsugu; Ikeda, Takanori; Koretsune, Yukihiro; Shimizu, Wataru; Tsutsui, Hiroyuki; Toyoda, Kazunori; Hirayama, Atsushi; Yasaka, Masahiro; Yamaguchi, Takenori; Teramukai, Satoshi; Kimura, Tetsuya; Kaburagi, Jumpei; Takita, Atsushi; Inoue, Hiroshi
• Is Part Of: Journal of cardiology. Volume 76:Issue 5(2020)
• Page Start: 446
• Page End: 452
• Publication Date: 2020-11
• Subjects: Atrial fibrillation -- Elderly -- Catheter ablation; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2020.06.015
• Languages: English
• ISSNs: 0914-5087

Abstract

Highlights: Characteristics of elderly atrial fibrillation (AF) patients differed by treatment. Patients treated with catheter ablation (CA) had better renal function. CA patients had higher incidence of paroxysmal AF than no-CA patients. More CA than no-CA patients received standard anticoagulant doses. More CA than no-CA patients had not received anticoagulant medication. Abstract: Background: Benefits of catheter ablation (CA) have been shown for patients with atrial fibrillation (AF), including elderly patients. However, data in patients aged ≥75 years who have undergone CA for non-valvular AF (NVAF) are lacking. This cross-sectional subanalysis of the ANAFIE registry determined the characteristics and status of anticoagulant treatment in elderly NVAF patients with a history of CA at enrollment. Method: The ANAFIE registry was a multicenter, prospective, non-interventional cohort study in which elderly ambulatory patients (≥75 years) diagnosed with NVAF by electrocardiogram were enrolled between October 2016 and January 2018. Treatment was prescribed per routine clinical practice by individual treating physicians. The patients were stratified into two groups: the CA and No-CA groups. Results: Among 32, 726 NVAF patients aged ≥75 years, 3002 (9.2%) underwent CA before enrollment. Patients who underwent CA were significantly younger (78.9 years vs 81.7 years; p < 0.0001), had significantly greater height and body weight, as well as creatinine clearance rate (CCr) compared with those who did not undergo CA. In both the CA and No-CA groups, the most common type of AF was paroxysmal AF (72.9% and 38.9%). In the CA group, a significantly larger proportion of patients did not receive anticoagulant therapy compared with the No-CA group (13.3% vs 7.6%; p < 0.0001). Direct oral anticoagulant (DOAC) use was similar in the CA (69.9%) and No-CA (66.0%) groups, and standard doses of DOACs were administered more frequently in the CA group than in the No-CA group. A lower proportion of patients in the CA group received warfarin (16.9% vs 26.4%) compared with the No-CA group. Conclusions: This ANAFIE registry subanalysis showed that patients with NVAF in the CA group tended to have paroxysmal AF; be significantly younger; have greater weight, height, and CCr; receive standard doses of DOACs; and have not used anticoagulant medication compared with No-CA patients.