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Catheter ablation for lone atrial fibrillation in individuals aged under 35 years

Published online by Cambridge University Press:  20 May 2019

Jindong Chen ,
Hao Wang ,
Mengmeng Zhou  and
Liang Zhao Open the ORCID record for Liang Zhao [Opens in a new window]
Jindong Chen
Affiliation:
Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
Hao Wang
Affiliation:
Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
Mengmeng Zhou
Affiliation:
Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
Liang Zhao*
Affiliation:
Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
*
Author for correspondence: Liang Zhao, Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. Tel: +86-21-22200000-2108; Fax: +86-21-22200000-2108. E-mail: [email protected]
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Abstract

Background:

To assess the effectiveness of radiofrequency catheter ablation for lone atrial fibrillation in young adults.

Methods:

This single-centre, retrospective, observational study enrolled 75 consecutive patients (86.7% men) under 35 (median, 30) years old with lone atrial fibrillation (68% paroxysmal, 26.7% persistent, and 5.3% long-standing persistent) without other cardiopulmonary diseases who underwent catheter ablation between April 2009 and May 2017. Procedural endpoints were circumferential pulmonary vein ablation for atrial fibrillation with pulmonary vein trigger, and target ablation or bidirectional block of lines and disappearance of complex fractionated atrial electrograms for atrial fibrillation with clear and unclear non-pulmonary vein triggers, respectively.

Results:

Main study outcome was rate of survival free from atrial tachyarrhythmia recurrence, which at median 61 (range, 5–102) months follow-up was 62.7% (64.7 and 58.3% for paroxysmal and non-paroxysmal atrial fibrillation, respectively) after single ablation, and 69.3% (68.6 and 70.8% for paroxysmal and non-paroxysmal atrial fibrillation, respectively) after mean 1.2 ablations (two and three ablations in 11 and 2 patients, respectively). In multivariate analysis, non-pulmonary vein trigger was a significant independent predictor of recurrent atrial tachyarrhythmia (OR, 10.60 [95%CI, 2.25–49.96]; p = 0.003). There were no major periprocedural adverse events.

Conclusions:

In patients under 35 years old with lone atrial fibrillation, radiofrequency catheter ablation appeared effective particularly for atrial fibrillation with pulmonary vein trigger and regardless of left atrial size or atrial fibrillation duration or type. Atrial tachyarrhythmia recurrence after multiple ablations warrants further study.

Keywords

Lone atrial fibrillationyoung patientscatheter ablationlong-term outcome
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 5 , May 2019 , pp. 643 - 648
Copyright
© Cambridge University Press 2019 

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