Allam Lamyaa, Samir Rania, Ali Ahmed Nabil
Cardiology Department, Ain Shams University, 48 Mohammed Elnadi street, s6th zone, Nasr City, P0 11371, Egypt.
Egypt Heart J. 2019 Sep 16;71(1):11. doi: 10.1186/s43044-019-0017-z.
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.
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.
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.
关于35岁以下成年人房颤导管消融的手术特征和临床结果的数据尚未得到充分探讨。目的是评估年轻成年人与老年人相比阵发性房颤导管消融的手术特征和临床结果。
2013年至2016年，76例有症状的阵发性房颤患者在艾因夏姆斯大学医院接受了肺静脉隔离术（PVI）。他们被分为两组，年轻人群组（平均年龄31.6±4.2岁，77%为男性）和老年人群组（平均年龄49±8.4岁，74%为男性）。记录手术前后的临床数据。随访基于门诊就诊，包括单次消融术后3个月、6个月和12个月的24小时动态心电图、心电图检查。复发定义为在3个月空白期后任何持续时间>30秒的房颤/房性心动过速发作。老年人群组的体重指数、CHA2DS2-VASc评分和左心房容积更高[P值分别为0.019、<0.001和0.001]。仅在22%的老年人群组中发现了低电压区，而年轻组中未发现[P=0.02]。所有患者均随访1年；老年组单次手术后1年无心律失常生存率为83.3%（25/30）和78.3%（36/46）[P=0.75]。两组均未记录并发症。老年组有4例患者和年轻组有1例患者进行了再次房颤消融。
非常年轻成年人的房颤导管消融1年成功率较高，但与老年人群的成功率相当。PAF的房颤消融在非常年轻的成年人中是有效的。
