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

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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.

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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

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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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Authors and Affiliations

  1. Cardioangiologisches Centrum Bethanien (CCB) Medizinische Klinik III Markus Krankenhaus, Wilhelm Epstein Str, 260431, Frankfurt am Main, Germany

    K. R. Julian Chun & Boris Schmidt

  2. Asklepios Klinik St, Georg, Hamburg, Germany

    Karl-Heinz Kuck

  3. Vivantes Klinik Urban, Berlin, Germany

    Dietrich Andresen

  4. Universitäres Herzzentrum, Hamburg, Germany

    Stefan Willems

  5. Praxisklinik Herz und Gefäße, Dresden, Germany

    Stefan G. Spitzer

  6. Städtisches Klinikum München-Bogenhausen, Munich, Germany

    Ellen Hoffmann

  7. Innere Medizin II, Westpfalz Klinikum Kaiserslautern, Kaiserslautern, Germany

    Burghard Schumacher

  8. Division of Clinical and Experimental Electrophysiology, Department of Cardiology and Angiology, University of Muenster, Münster, Germany

    Lars Eckardt

  9. Medizinische Klinik IV, Klinikum Ingolstadt, Ingolstadt, Germany

    Karlheinz Seidl

  10. Institute for Research in Myocardial Infarction, Ludwigshafen, Germany

    Claus Jünger, Martin Horack & Jochen Senges

  11. Klinikum Coburg, Coburg, Germany

    Johannes Brachmann

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  1. K. R. Julian Chun
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  2. Boris Schmidt
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Correspondence to K. R. Julian Chun.

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Table 5 Participating centers
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Chun, K.R.J., Schmidt, B., Kuck, KH. et al. Catheter ablation of atrial fibrillation in the young: insights from the German Ablation Registry. Clin Res Cardiol 102, 459–468 (2013). https://doi.org/10.1007/s00392-013-0553-6

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  • DOI: https://doi.org/10.1007/s00392-013-0553-6

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