Arrhythmias & electrophysiologyCohort study
Young-Onset Atrial Fibrillation
- multicenter retrospective cohort study
Authors' conclusion
Young-onset AF was associated with a significant rate of adverse events, with genetic and structural heart abnormalities conferring the worst prognosis. Young patients continue to do well after catheter ablation, although late gadolinium enhancement may identify a group at particularly high risk.
Study context
- Population
- Adults diagnosed with a first episode of atrial fibrillation (AF) at age ≤45 years with normal left ventricular function and referred for catheter ablationpatients (mean age 34.8 ± 7.7 years, 79% male)
- Participants
- 203 adults
- Exposure
- Young-onset AF vs Comparator cohort
- Young-onset AFn = 203
Main finding
As reported in the abstract
Major adverse cardiovascular and cerebrovascular events (MACCE) occurred in patients
28%
Observational data: associations, not effects.
Further findings
New left ventricular dysfunction · median follow-up of 4.9 years (Q1-Q3: 2.5-10.2 years)
- New left ventricular dysfunction developed in cases
- 13%
Event burden by AF etiology
- Genetic, alcohol, or structural heart disease-associated AF etiology was associated with the highest event burden
- Idiopathic, non-pulmonary vein triggers, exercise, and vagal-associated AF displayed a more favorable prognosis
Recurrence after catheter ablation
- Catheter ablation performed
- 180 (88.7%) patients
- Recurrence
- 70 (39%) patients
- Median time to recurrence
- 4.3 months (Q1-Q3: 1.5-10.4 months)
Late gadolinium enhancement as predictor of MACCE and recurrence-free survival
- Presence of late gadolinium enhancement predicted MACCE and shorter recurrence-free survival
- P < 0.01
Ejection fraction
- Mean ejection fraction
- 59% ± 5%
Original publication
Summarised from the published abstract; every number is checked against it