Efficacy and benefits of catheter ablation of ventricular premature complexes in patients younger and older than 65 years of age

Objectives: Catheter ablation of ventricular premature complexes (VPC) improves clinical status and systolic performance of the left ventricle (LV) in a certain subset of patients; however, whether or not VPC ablation is equally effective in younger (≤65 years) and older (>65 years) patients remains unclear. We aimed to assess the clinical benefits of catheter ablation of VPCs in elderly patients. Study design: Fifty-one consecutive patients (66±10 years, 49 male) who underwent catheter ablation for symptomatic VPCs were included into the study. Twenty-seven patients were aged >65 years and 24 patients ≤65 years. Frequency of VPCs per total heart beats by 24-hour Holter monitoring, LV ejection fraction (LVEF) and end-systolic diameters (LVEDD) were evaluated before and 6±3 months after ablation. Results: The pre-ablation 24-hour VPC burden and VPC number were significantly higher in patients >65 years compared to those ≤65 years (31±15.3 vs. 21.9±12.6, p=0.04 and 34493±21226 vs. 23554±13792, p=0.026, respectively). At the follow-up after catheter ablation, the mean VPC burden had decreased to 9.1±10.3% (p<0.001) in patients >65 years and to 3.8±7.1 (p<0.001) in patients ≤65 years. Mean LVEF showed a significant increase in both groups after ablation (43.4±10.4 vs. 51.5±8.2, p=0.005 for age >65 years and 40.8±13.2 vs. 49.5±11.8, p=0.003 for age ≤65 years). The improvement in LVEF was accompanied by a significant decrease in LVEDD (p=0.032 for age >65 years and p=0.047 for ≤65 years). Conclusion: Catheter ablation is effective for treatment of frequent VPCs in all age groups.