Purpose of review: Atrial fibrillation is increasingly prevalent among older adults and is a major contributor to morbidity in this population due to associated strokes, heart failure, and quality of life impairment. Catheter ablation for atrial fibrillation is demonstrated to be superior to antiarrhythmic therapy for the control of symptomatic and medically refractory atrial fibrillation, but its safety and efficacy in the elderly are not well understood. Clinical trials to guide the optimal management strategy in this population are lacking.
Recent findings: Several nonrandomized clinical studies have recently addressed the issue of catheter ablation in the elderly and show favorable rates of success. Unfortunately, these studies are limited by the relatively small numbers of patients examined and often by their single-center and retrospective nature.
Summary: Before the results of these studies can be extrapolated, data from larger cohorts of elderly patients followed prospectively are desperately needed.