Clinical Characteristics and Outcomes of Catheter Ablation in Young Patients With Atrial Fibrillation

Abstract

Background: Data concerning young patients with atrial fibrillation (AF) are currently limited. Hypothesis: This study aimed to assess the clinical characteristics and risk factors for AF recurrence in young patients following catheter ablation (CA). Methods: All AF patients aged ≤ 45 years who underwent CA were identified from the China Atrial Fibrillation Center database between September 2018 and September 2023. Baseline clinical characteristics, procedural details, and follow-up outcomes were compared between the paroxysmal and non-paroxysmal cohorts. Results: A total of 6,531 young patients with AF were included in the final analysis, with an average age of 37.7 ± 5.5 years, 77.1% were male, and 65.2% with paroxysmal AF. The primary comorbidities were hypertension (16.2%), heart failure (8.4%), valvular heart disease (3.5%), diabetes mellitus (3.2%), peripheral arterial disease (2.8%), stroke/transient ischemic attack (2.5%), and cardiomyopathy (2.2%). Following CA, the recurrence rate of AF post-CA was 14.4% across the entire cohort, with a lower recurrence rate in the paroxysmal AF group compared to the non-paroxysmal AF group (10.6% vs. 19.7%, p < 0.001). Non-paroxysmal AF (HR 2.34, 95% CI 1.62 to 3.36, p < 0.001) and hypertension (HR 1.69, 95% CI 1.09 to 2.63, p = 0.019) were identified as independent predictors for AF recurrence. Conclusion: Young AF patients who undergo CA exhibit a low recurrence rate and a notable improvement in symptoms post-CA. Non-paroxysmal AF and hypertension emerge as primary contributors to AF recurrence following CA in this population.