Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Department of Cardiovascular Disease, Southern Illinois University School of Medicine, Springfield, IL, USA.
BMC Cardiovasc Disord. 2023 Feb 11;23(1):83. doi: 10.1186/s12872-022-03017-6.
Atrial fibrillation (AF) is relatively less frequent in younger patients (age < 50). Recently, studies have suggested that early restoration of sinus rhythm may lead to improved outcomes compared with rate control, however the efficacy of catheter ablation for AF in young is scarce.
We included all hospitalized patients between 18 and 50 years with a diagnosis of AF from the Nationwide Readmission Database 2016-2017 from the Healthcare Cost and Utilization Project. Demographic and comorbidity data were collected and analyzed. Outcomes assessed included one-year AF readmission rates, all-cause readmission, ischemic stroke, and all-cause mortality. Subgroup analyses were performed for all demographic and comorbidity variables.
Overall, 52,598 patients (medium age 44, interquartile range 38-48, female 25.7%) were included in the study, including 2,146 (4.0%) who underwent catheter ablation for AF. Patients who underwent catheter ablation had a significantly lower rate of readmission for AF or any cause at one year (adjusted hazard ratios (HR) of 0.52 [95% confidence interval (CI): 0.43-0.63] and HR of 0.81 [95% CI: 0.72-0.89], respectively). There was no difference in 1-year readmission for stroke or all-cause mortality between the two groups. Subgroup analyses showed a consistent reduction in the risk of AF readmission among major demographic and comorbidity subgroups.
Catheter ablation in young patients with AF was associated with a reduction in 1-year AF related and all-cause readmissions. These data merit further prospective investigation for validation, through dedicated registries and multicenter collaborations to include young AF from diverse population.
心房颤动（AF）在年轻患者（年龄<50 岁）中相对较少见。最近的研究表明，与控制心率相比，早期恢复窦性心律可能会带来更好的结果，然而，关于年轻患者中 AF 的导管消融疗效的数据却很少。
我们纳入了 2016 年至 2017 年医疗保健成本和利用项目的全国再入院数据库中年龄在 18 至 50 岁之间、诊断为 AF 的所有住院患者。收集并分析了人口统计学和合并症数据。评估的结果包括一年 AF 再入院率、全因再入院、缺血性卒中和全因死亡率。对所有人口统计学和合并症变量进行了亚组分析。
总体而言，本研究共纳入 52598 例患者（平均年龄为 44 岁，四分位间距为 38-48 岁，女性占 25.7%），其中 2146 例（4.0%）患者接受了导管消融治疗 AF。接受导管消融治疗的患者在一年时 AF 或任何原因的再入院率显著降低（校正后的风险比（HR）分别为 0.52（95%置信区间（CI）：0.43-0.63）和 0.81（95%CI：0.72-0.89））。两组之间 1 年内因中风或全因死亡率再入院的差异无统计学意义。亚组分析显示，在主要人口统计学和合并症亚组中，AF 再入院的风险均降低。
在年轻的 AF 患者中进行导管消融与降低 1 年内 AF 相关和全因再入院率相关。这些数据需要进一步通过专门的登记处和多中心合作进行前瞻性研究，以包括来自不同人群的年轻 AF 患者，以验证这些数据。
