Catheter Ablation for Atrial Fibrillation in Patients ≤30 Years of Age

Pulmonary vein (PV) automaticity is an established trigger for paroxysmal atrial fibrillation (PAF), making PV isolation (PVI) the cornerstone of catheter ablation. However, data on triggers for atrial fibrillation (AF) and catheter ablation strategy in very young patients aged 30 seconds after a 3-...

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Bibliographic Details
Published in:The American journal of cardiology 2022-03, Vol.166, p.53-57
Main Authors: Yalin, Kivanc, Ikitimur, Baris, Aksu, Tolga, Ozcan, Emin Evren, Ding, Wern Yew, Soysal, Ali Ugur, Lyan, Evgeny, Eitel, Charlotte, Saygi, Serkan, Turan, Oguzhan Ekrem, Hegeer, Christian Hendrik, Tilz, Roland Richard, Gupta, Dhiraj
Format: Article
Language:English
Subjects:
Ablation
Adult
Age
Atrial Fibrillation - diagnosis
Atrial Flutter
Automation
Blanking
Blood clots
Cardiac arrhythmia
Cardiovascular diseases
Catheter Ablation
Catheters
Complications
Coronary artery disease
Cryosurgery - methods
EKG
Electrocardiography
Electrophysiology
Female
Fibrillation
Flutter
Genetics
Heart diseases
Hematoma
Humans
Male
Medical instruments
Patients
Pulmonary Veins - surgery
Radio frequency
Radiofrequency ablation
Recurrence
Signs and symptoms
Substrates
Tachyarrhythmia
Tachycardia
Tachycardia, Atrioventricular Nodal Reentry - diagnosis
Tachycardia, Atrioventricular Nodal Reentry - surgery
Tachycardia, Paroxysmal - surgery
Tachycardia, Supraventricular
Treatment Outcome
Vibration
Young Adult
Young adults
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Summary:Pulmonary vein (PV) automaticity is an established trigger for paroxysmal atrial fibrillation (PAF), making PV isolation (PVI) the cornerstone of catheter ablation. However, data on triggers for atrial fibrillation (AF) and catheter ablation strategy in very young patients aged 30 seconds after a 3-month blanking period. A total of 2 patients with atrioventricular nodal reentrant tachycardia, 1 with left atrial appendage tachycardia, experienced AF recurrence within the first 3 months and received PVI. After the 3-month blanking period, during a median follow-up of 17.0 ± 10.1 months, 44 of 51 patients (86.2%) were free of ATA recurrence. In the PVI group, 33 of 39 patients (84.6%) experienced no ATA recurrence. In conclusion, SVT substrate is identified in around a quarter of young adult patients with history of AF, and targeted ablation without PVI may be sufficient in the majority of these patients. PVI is needed in the majority and is safe and effective in this population.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2021.11.020