Safety and Efficacy of Cryoballoon Pulmonary Vein Isolation and Left Atrial Appendage Closure Combined Procedure and Half-Dose Rivaroxaban After Operation in Elderly Patients with Atrial Fibrillation

Figures & data

Table 1 Baseline Demographic Characteristics

Parameters	Elderly Group (n=83)	Non-Elderly Group (n=120)	P-value
Age (years)	82.6 ± 1.7	69.2 ± 7.4	< 0.001
Gender (female) (n, %)	43 (51.8%)	63 (52.5%)	1
CHA2DS2-VASc score	6.4 ± 1.2	4.7 ± 1.7	< 0.001
HAS-BLED score	3.6 ± 0.9	3.07 ± 0.8	< 0.001
Persistent atrial fibrillation (n, %)	45 (54.2%)	58 (48.3%)	0.48
Heart Failure (n, %)	71 (85.5%)	18 (15%)	< 0.001
Left atrial diameter (mm)	44.2 ± 2.5	43.8 ± 2.4	0.23

Table 2 Periprocedural Data

Parameters	Elderly Group	Non-Elderly Group	P-value
Numbers of pulmonary vein (n)	4.05 ± 0.3	4.04 ± 0.3	0.89
Pulmonary vein isolation rate (n, %)	336 (100%)	485 (100%)	1
Cryoablation procedure time (min)	74.2 ± 6.2	72.9 ± 4.9	0.08
Devices (n, %)
Lacbes	29 (35%)	55 (46%)	0.15
WATCHMAN	54 (65%)	65 (54%)
Successful implantation, (n, %)	83 (100%)	120 (100%)	1
Left atrial appendage closure procedure time (min)	30.1 ± 3.9	30.4 ± 3.4	0.56
Complications (n, %)	1 (1.2%)	1 (0.8%)	1
Death	0 (0%)	0 (0%)	-
Cerebral infarction/transient ischemic attack	0 (0%)	0 (0%)	-
Pericardial tamponade	0 (0%)	1 (0.8%)	1
Hemorrhage	0 (0%)	0 (0%)	-
Phrenic nerve injury	0 (0%)	0 (0%)	-
Puncture complications	1 (1.2%)	0 (0%)	0.41
Acute kidney injury	0 (0%)	0 (0%)	-
Acute liver injury	0 (0%)	0 (0%)	-
Residual flow > 3mm	0 (0%)	0 (0%)	-
Anticoagulation protocol (within 2 months after surgery)
Rivaroxaban (n, %)	69 (83.2%)	90 (75%)	0.22
Rivaroxaban + Clopidogrel (n, %)	14 (16.8%)	30 (25%)	0.22

Table 3 Follow-Up Outcomes

Parameters	Elderly Group	Non-Elderly Group	P-value
Clinical composite events	7 (8.4%)	11 (9.2%)	0.53
Recurrence of atrial fibrillation	25 (30.1%)	32 (26.7%)	0.59
Death	0 (0%)	0 (0%)	-
Cerebral infarction/transient ischemic attack	2 (2.4%)	2 (1.7%)	0.78
Peripheral arterial thrombosis	0 (0%)	0 (0%)	-
Pericardial tamponade	1 (1.2%)	2 (1.7%)	0.79
Major hemorrhage	1 (1.2%)	5 (4.2%)	0.22
Displacement of devices	0 (0%)	0 (0%)	-
Device-related thrombosis	3 (3.6%)	2 (1.7%)	0.38
Residual flow > 3mm	0 (0%)	0 (0%)	-

Figure 1 Survival curves for the annual composite event rate.

Figure 2 Freedom from atrial fibrillation by survival analysis.

Figure 3 Annualized arterial embolism (A) and bleeding (B) rate reduction from CHA₂DS₂-VASc and HAS-BLED score predicted rates in our population after the combined procedure.