Clinical Characteristics and Outcomes of Catheter Ablation in Young Patients With Atrial Fibrillation

Background

Data concerning young patients with atrial fibrillation (AF) are currently limited.

Hypothesis

This study aimed to assess the clinical characteristics and risk factors for AF recurrence in young patients following catheter ablation (CA).

Methods

All AF patients aged ≤ 45 years who underwent CA were identified from the China Atrial Fibrillation Center database between September 2018 and September 2023. Baseline clinical characteristics, procedural details, and follow-up outcomes were compared between the paroxysmal and non-paroxysmal cohorts.

Results

A total of 6,531 young patients with AF were included in the final analysis, with an average age of 37.7 ± 5.5 years, 77.1% were male, and 65.2% with paroxysmal AF. The primary comorbidities were hypertension (16.2%), heart failure (8.4%), valvular heart disease (3.5%), diabetes mellitus (3.2%), peripheral arterial disease (2.8%), stroke/transient ischemic attack (2.5%), and cardiomyopathy (2.2%). Following CA, the recurrence rate of AF post-CA was 14.4% across the entire cohort, with a lower recurrence rate in the paroxysmal AF group compared to the non-paroxysmal AF group (10.6% vs. 19.7%, p < 0.001). Non-paroxysmal AF (HR 2.34, 95% CI 1.62 to 3.36, p < 0.001) and hypertension (HR 1.69, 95% CI 1.09 to 2.63, p = 0.019) were identified as independent predictors for AF recurrence.

Conclusion

Young AF patients who undergo CA exhibit a low recurrence rate and a notable improvement in symptoms post-CA. Non-paroxysmal AF and hypertension emerge as primary contributors to AF recurrence following CA in this population.