Catheter ablation of atrial fibrillation in the young: insights from the German Ablation Registry

Clin Res Cardiol. 2013 Jun;102(6):459-68. doi: 10.1007/s00392-013-0553-6. Epub 2013 Mar 17.

Abstract

Introduction: Catheter ablation of paroxysmal atrial fibrillation (PAF) has been suggested as first-line treatment for selected patients (pts). However, patient characteristics, procedural data, and complication rate in the group of young patients remain undetermined.

Methods: The German Ablation Registry has been designed as a multi-center prospective registry. AF ablation data were collected from 51 German centers between March 2007 to September 2012 and 2 groups were defined (group A: ≤45 years, group B: >45 years). Data were analyzed according to patient characteristics, procedural data, and complications. To calculate differences between both groups CHI2 or Mann-Whitney-Wilcoxon tests was utilized.

Results: A total of 7243 patients undergoing AF ablation were included (group A: 593, 8.2 %; group B: 6650, 91.8 %). Male gender and PAF were significantly more often present in group A. Patient characteristic revealed decreased co-morbidities in the young. In both groups circumferential pulmonary vein isolation represented the procedural cornerstone, whereas substrate modification was significantly more often performed in group B. Procedure-, and fluoroscopy-time was similar but there was a shorter hospital stay and a favorable complication profile in the young. After 12 months AF recurrence and use of antiarrhythmic drugs were less common in group A.

Conclusion: The young AF ablation patient has typically paroxysmal AF and less comorbidities. In this group, catheter ablation of AF is associated with a lower major complication rate, shorter hospitalization, and a favorable clinical outcome.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Atrial Fibrillation / surgery*
  • Catheter Ablation / methods*
  • Female
  • Fluoroscopy
  • Follow-Up Studies
  • Germany
  • Hospitalization / statistics & numerical data
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Prospective Studies
  • Pulmonary Veins / surgery*
  • Recurrence
  • Registries
  • Sex Factors
  • Statistics, Nonparametric
  • Time Factors
  • Treatment Outcome