Efficacy and Risk of Atrial Fibrillation Ablation Before 45 Years of Age

医学 心房颤动 导管消融 烧蚀 内科学 并发症 B组 心脏病学 外科 麻醉
作者
Peter Leong‐Sit,Erica S. Zado,David J. Callans,Fermin C. García,David Lin,Sanjay Dixit,Rupa Bala,Michael P. Riley,Mathew D. Hutchinson,Joshua M. Cooper,Edward P. Gerstenfeld,Francis E. Marchlinski
出处
期刊:Circulation-arrhythmia and Electrophysiology [Lippincott Williams & Wilkins]
卷期号:3 (5): 452-457 被引量:83
标识
DOI:10.1161/circep.110.938860
摘要

Young patients with atrial fibrillation (AF) tend to be more symptomatic and less willing to take long-term medications, yet catheter ablation remains recommended as second-line therapy for AF regardless of age. This study seeks to characterize the effectiveness and risk of AF ablation in the young.Consecutive (n=1548) patients who underwent 2038 AF ablation procedures were included. Major procedural complications and efficacy were analyzed on the basis of age at the initial procedure: <45 years (group 1), 45 to 54 years (group 2), 55 to 64 years (group 3), and ≥65 years (group 4). AF control was defined as no or rare AF on or off antiarrhythmic drugs. The primary outcome of AF control was similar in all groups; it was achieved in 87% in group 1, 88% in group 2, 88% in group 3, and 82% in group 4 (P=0.06). However, more group 1 patients demonstrated freedom from AF off antiarrhythmic drugs (76%) compared with group 2 at 68%, group 3 at 65%, and group 4 at 53% (P<0.001). There were no major complications in group 1, 10 (1.7%) in group 2, 14 (1.4%) in group 3, and 10 (2.6%) in group 4 (P=0.01).In patients younger than 45 years, there is a lower major complication rate and a comparable efficacy rate, with a greater chance of being AF free without antiarrhythmic drugs. These findings suggest that it may be appropriate to consider ablative therapy as first-line therapy in this age group.
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