Clinical outcomes of catheter ablation of paroxysmal atrial fibrillation in very young population compared to older population: a prospective study

BACKGROUND: Data on procedural characteristics and clinical outcome of catheter ablation of atrial fibrillation (AF) in adults younger than 35 years has not been sufficiently addressed. The aim is to assess procedural characteristics and clinical outcome of catheter ablation of paroxysmal atrial fibrillation in young adults in comparison to older adults. RESULTS: Seventy-six consecutive patients with symptomatic paroxysmal AF underwent pulmonary vein isolation (PVI) at Ain Shams University Hospitals from 2013 till 2016. They were divided into the two groups, young population group (mean age 31.6 ± 4.2 years, 77% men) and older population group (mean age 49 ± 8.4 years, 74% men). Clinical data before and during the procedure were recorded. Follow-up was based on outpatient visits including 24 h Holter, ECG at 3, 6, and, 12 months post single ablation procedure. Recurrence was defined as any AF/atrial tachycardia episode > 30 s following a 3-month blanking period. Body mass index, CHA2DS2-VASc score, and left atrial volume were higher in the older population group [P values 0.019, < 0.001, and 0.001, respectively]. The presence of low-voltage areas was found only in 22% of the older population group and not in the younger group [P 0.02]. All patients were followed up for 1 year; 1-year arrhythmia-free survival after a single procedure was 83.3% (25/30) and 78.3% (36/46) in the older group [P 0.75]. No complications were recorded in both groups. Redo AF ablation were done for four patients in the old group and one patient in the young group. CONCLUSIONS: Catheter ablation of AF in very young adults is associated with higher 1-year success rates but comparable to success rates in older populations. AF ablation for PAF is effective in very young adults.