Dewire Jane, Agarwal Sunil, Khurram Irfan K, Marine Joseph E, Berger Ronald, Spragg David, Ashikaga Hiroshi, Rickard John, Nazarian Saman, Calkins Hugh
Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Medicine, Division of Internal Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
J Atr Fibrillation. 2013 Oct 31;6(3):915. doi: 10.4022/jafib.915. eCollection 2013 Oct-Nov.
Outcome of catheter ablation of atrial fibrillation (AF) in young patients has not been widely reported. This study describes the safety and efficacy of radiofrequency catheter ablation (RFA) for atrial fibrillation in patients forty years or younger. Forty consecutive patients who underwent fifty-two RFA procedures for symptomatic, drug-refractory paroxysmal or non-paroxysmal AF were included in the study. The mean (SD) age of the patients at time of initial procedure was 34.1 (5.6) years. Twenty-five (62.5%) patients had paroxysmal AF, 6 (15%) patients had persistent AF, and 9 (22.5%) patients had longstanding persistent AF. Procedural safety and efficacy were assessed based on patient status > 1 year after initial ablation procedure. After a mean (SD) follow-up of 3.8 (2.9) years, 25 (62.5%) patients were free of AF without antiarrhythmic drugs (AAD) and 40 (100%) patients experienced > 95% reduction of AF burden on or off AADs. No major complications or adverse events occurred during the study. Catheter ablation of AF is a favorable therapeutic option for patients 40 years or younger, resulting in high rates of procedural success with a low risk of major complications.
年轻患者心房颤动（AF）导管消融的结果尚未得到广泛报道。本研究描述了射频导管消融（RFA）治疗40岁及以下患者心房颤动的安全性和有效性。该研究纳入了40例连续接受52次RFA手术治疗有症状、药物难治性阵发性或非阵发性AF的患者。初次手术时患者的平均（标准差）年龄为34.1（5.6）岁。25例（62.5%）患者为阵发性AF，6例（15%）患者为持续性AF，9例（22.5%）患者为长期持续性AF。根据初次消融手术后1年以上的患者状态评估手术安全性和有效性。平均（标准差）随访3.8（2.9）年后，25例（62.5%）患者在未使用抗心律失常药物（AAD）的情况下无AF发作，40例（100%）患者无论是否使用AAD，AF负荷均降低>95%。研究期间未发生重大并发症或不良事件。AF导管消融对于40岁及以下患者是一种有利的治疗选择，手术成功率高，重大并发症风险低。
