Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan.
Pacing Clin Electrophysiol. 2021 Oct;44(10):1724-1732. doi: 10.1111/pace.14347. Epub 2021 Sep 5.
Atrial fibrillation (AF) prevalence increases with age. Aging affects the substrate properties of the left atrium (LA) and the outcomes of catheter ablation for treating AF. We investigated the AF trigger distribution and catheter ablation outcomes in patients of different ages with AF.
1585 patients with AF (1181 paroxysmal and 404 non- paroxysmal AF) who had undergone catheter ablation were enrolled. The patients were divided into young (20-40 year-old, n = 175), middle-aged (41-64 year-old, n = 1134), and old (≥ 65 year-old, n = 276) groups. Electrophysiological characteristics and AF trigger sites were recorded.
The incidence of AF with only non-pulmonary vein (non-PV) foci was higher in the young group than in the other groups (8.6% vs. 3.6% vs. 3.3%, p < 0.01). Non-PV foci were more commonly located in the superior vena cava (SVC) in the young group than in the other groups (13.1% vs. 7.8% vs. 6.5%, p = 0.03). The left atrium (LA) mean voltage was higher and the incidence of very late recurrence after AF ablation was lower in the young group than in the other groups. However, the final AF recurrence rate after multiple procedures and complication rates were similar among all the groups at a mean follow-up of 5.6 years.
The young patients with AF had a higher incidence of only non-PV foci, mostly located in SVC, than the middle-aged and old patients. Our study highlights the importance of identifying the non-PV foci in catheter ablation of young patients with AF.
心房颤动（AF）的患病率随年龄增长而增加。衰老会影响左心房（LA）的基质特性和导管消融治疗 AF 的结果。我们研究了不同年龄段 AF 患者的 AF 触发灶分布和导管消融治疗结果。
共纳入 1585 例接受导管消融治疗的 AF 患者（1181 例阵发性 AF 和 404 例非阵发性 AF），将患者分为青年组（20-40 岁，n=175）、中年组（41-64 岁，n=1134）和老年组（≥65 岁，n=276）。记录电生理特征和 AF 触发灶。
青年组 AF 仅伴有非肺静脉（non-PV）灶的发生率高于其他两组（8.6%比 3.6%比 3.3%，p<0.01）。青年组 non-PV 灶更常见于上腔静脉（SVC）（13.1%比 7.8%比 6.5%，p=0.03）。与其他两组相比，青年组 LA 平均电压较高，消融后 AF 晚期复发发生率较低。然而，在平均 5.6 年的随访中，所有三组多次消融后 AF 复发率和并发症发生率相似。
与中、老年患者相比，青年 AF 患者仅伴有非-PV 灶的发生率较高，且多位于 SVC。本研究强调了在对青年 AF 患者进行导管消融时识别非-PV 灶的重要性。
