{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T22:09:20Z","timestamp":1771625360804,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T00:00:00Z","timestamp":1665705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: Cryoballoon pulmonary vein isolation (cryoPVI) is established for symptomatic paroxysmal atrial fibrillation (AF) treatment, but its value in persistent AF is less clear. In particular, limited data are available on its efficacy in elderly patients (\u226575 years) with persistent AF. Age is an important modifier of AF progression and represents a risk-factor for AF recurrence. (2) Methods: Prospective, single-center observational study to evaluate the impact of age on efficacy and safety of cryoPVI in elderly patients. Primary efficacy endpoint was symptomatic AF recurrence after 90-day blanking period. Primary safety endpoints were death from any cause, procedure-associated complications or stroke\/transient ischemic attack. Median follow-up was 17 months (range 3\u201324). (3) Results: We included 268 patients with persistent AF (94 \u2265 75 years of age). Multivariate Cox regression analysis identified age as the only independent factor influencing AF recurrence in the overall cohort (p = 0.006). To minimize confounding bias in efficacy and safety analysis of cryoPVI, we matched younger and elderly patients with respect to baseline characteristics. At 24 months, primary efficacy endpoint occurred in 13\/69 patients &lt;75 years and 31\/69 patients \u226575 years of age (24 months Kaplan\u2013Meier event-rate estimates, HR 0.34; 95% CI, 0.19 to 0.62; log-rank p = 0.0004). No differences were observed in the occurrence of safety end points. (4) Conclusions: Elderly (\u226575 years) patients with persistent AF undergoing cryoPVI had an approximately threefold higher risk of symptomatic AF recurrence than matched younger patients. Accordingly, other treatment modalities may be evaluated in this population.<\/jats:p>","DOI":"10.3390\/jcm11206070","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T02:29:46Z","timestamp":1665973786000},"page":"6070","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Persistent Atrial Fibrillation in Elderly Patients: Limited Efficacy of Pulmonary Vein Isolation"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2306-1370","authenticated-orcid":false,"given":"Andreas A.","family":"Boehmer","sequence":"first","affiliation":[{"name":"Department of Cardiology, St. Josefs-Hospital Wiesbaden, Beethovenstra\u00dfe 20, 65189 Wiesbaden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moritz","family":"Rothe","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Josefs-Hospital Wiesbaden, Beethovenstra\u00dfe 20, 65189 Wiesbaden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celine","family":"Zezyk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Josefs-Hospital Wiesbaden, Beethovenstra\u00dfe 20, 65189 Wiesbaden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina M.","family":"Soether","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Josefs-Hospital Wiesbaden, Beethovenstra\u00dfe 20, 65189 Wiesbaden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca C.","family":"Dobre","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Josefs-Hospital Wiesbaden, Beethovenstra\u00dfe 20, 65189 Wiesbaden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernhard M.","family":"Kaess","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Josefs-Hospital Wiesbaden, Beethovenstra\u00dfe 20, 65189 Wiesbaden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim R.","family":"Ehrlich","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Josefs-Hospital Wiesbaden, Beethovenstra\u00dfe 20, 65189 Wiesbaden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"448.e1","DOI":"10.1016\/j.amjmed.2005.10.057","article-title":"Quality of life in patients with atrial fibrillation: A systematic review","volume":"119","author":"Thrall","year":"2006","journal-title":"Am. 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