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Clinical Research in Cardiology

, Volume 102, Issue 6, pp 459–468 | Cite as

Catheter ablation of atrial fibrillation in the young: insights from the German Ablation Registry

  • K. R. Julian ChunEmail author
  • Boris Schmidt
  • Karl-Heinz Kuck
  • Dietrich Andresen
  • Stefan Willems
  • Stefan G. Spitzer
  • Ellen Hoffmann
  • Burghard Schumacher
  • Lars Eckardt
  • Karlheinz Seidl
  • Claus Jünger
  • Martin Horack
  • Johannes Brachmann
  • Jochen Senges
Original Paper

Abstract

Introduction

Catheter ablation of paroxysmal atrial fibrillation (PAF) has been suggested as first-line treatment for selected patients (pts). However, patient characteristics, procedural data, and complication rate in the group of young patients remain undetermined.

Methods

The German Ablation Registry has been designed as a multi-center prospective registry. AF ablation data were collected from 51 German centers between March 2007 to September 2012 and 2 groups were defined (group A: ≤45 years, group B: >45 years). Data were analyzed according to patient characteristics, procedural data, and complications. To calculate differences between both groups CHI2 or Mann–Whitney–Wilcoxon tests was utilized.

Results

A total of 7243 patients undergoing AF ablation were included (group A: 593, 8.2 %; group B: 6650, 91.8 %). Male gender and PAF were significantly more often present in group A. Patient characteristic revealed decreased co-morbidities in the young. In both groups circumferential pulmonary vein isolation represented the procedural cornerstone, whereas substrate modification was significantly more often performed in group B. Procedure-, and fluoroscopy-time was similar but there was a shorter hospital stay and a favorable complication profile in the young. After 12 months AF recurrence and use of antiarrhythmic drugs were less common in group A.

Conclusion

The young AF ablation patient has typically paroxysmal AF and less comorbidities. In this group, catheter ablation of AF is associated with a lower major complication rate, shorter hospitalization, and a favorable clinical outcome.

Keywords

Catheter ablation Atrial fibrillation Young patient 

Abbreviations

AAD

Antiarrhtyhmic drug

AF

Atrial fibrillation

CA

Catheter ablation

CFAE

Complex fractionated atrial electrograms

CT

Computed tomography

IQR

Interquartile range

PV

Pulmonary vein

MACE

Major adverse cardiac events

MACCE

Major adverse cardiac and cerebrovascular events

MRI

Magnetic resonance imaging

RFC

Radiofrequency current

Notes

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest influenced by the article’s content.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • K. R. Julian Chun
    • 1
    Email author
  • Boris Schmidt
    • 1
  • Karl-Heinz Kuck
    • 2
  • Dietrich Andresen
    • 3
  • Stefan Willems
    • 4
  • Stefan G. Spitzer
    • 5
  • Ellen Hoffmann
    • 6
  • Burghard Schumacher
    • 7
  • Lars Eckardt
    • 8
  • Karlheinz Seidl
    • 9
  • Claus Jünger
    • 10
  • Martin Horack
    • 10
  • Johannes Brachmann
    • 11
  • Jochen Senges
    • 10
  1. 1.Cardioangiologisches Centrum Bethanien (CCB) Medizinische Klinik III Markus KrankenhausFrankfurt am MainGermany
  2. 2.Asklepios Klinik StHamburgGermany
  3. 3.Vivantes Klinik UrbanBerlinGermany
  4. 4.Universitäres HerzzentrumHamburgGermany
  5. 5.Praxisklinik Herz und GefäßeDresdenGermany
  6. 6.Städtisches Klinikum München-BogenhausenMunichGermany
  7. 7.Innere Medizin II, Westpfalz Klinikum KaiserslauternKaiserslauternGermany
  8. 8.Division of Clinical and Experimental Electrophysiology, Department of Cardiology and AngiologyUniversity of MuensterMünsterGermany
  9. 9.Medizinische Klinik IV, Klinikum IngolstadtIngolstadtGermany
  10. 10.Institute for Research in Myocardial InfarctionLudwigshafenGermany
  11. 11.Klinikum CoburgCoburgGermany

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