Effects of catheter ablation on the clinical outcomes of young patients aged ≤35 years with atrial fibrillation: A retrospective study

The effects of catheter ablation for atrial fibrillation (AF) on the prognosis of patients aged ≤ 35 years are uncertain. We investigated the predictors of AF recurrence and evaluated the effects of catheter ablation for AF on prognosis in this population. The data of 156 consecutive patients aged ≤ 35 years with AF were retrospectively analyzed, including 92 (59.0%) treated by catheter ablation (ablation group) and 64 (41.0%) treated with pharmacological therapy without ablation (non-ablation group). The primary outcomes were AF recurrence and cardiovascular-related hospitalization. During the mean follow-up of 33.9 ± 20.7 months, freedom from recurrent atrial tachyarrhythmia was 67.4% after the 1st ablation and 76.1% after repeat ablations. Multivariable predictors of recurrent atrial tachyarrhythmia were left atrial diameter (hazard ratio [HR]: 1.09, 95% confidence interval [CI]: 1.02-1.17; P = .010) and family history of AF (HR: 3.77, 95% CI: 1.68-8.49; P = .001). Kaplan-Meier curves for the incidence of cardiovascular-related hospitalization showed that event-free rates were significantly higher in the ablation group than in the non-ablation group (P < .001). In the multivariable analysis, catheter ablation therapy (HR: 0.36, 95% CI: 0.19-0.67; P = .001) and heart failure at baseline (HR: 2.63, 95% CI: 1.26-5.52; P = .010) were independent predictors of cardiovascular-related hospitalization. Among patients aged ≤ 35 years with AF, catheter ablation was associated with a significantly lower risk of cardiovascular-related hospitalization than conventional pharmacological therapy. Family history of AF and left atrial diameter predicted poorer outcomes after catheter ablation.