Long Term Results of Catheter Ablation for Paroxysmal Atrial Fibrillation in Patients Less Than 50 Years Old

概要

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Backgrounds: Because of increasing elderly patients with atrial fibrillation (AF), extensive pulmonary veins isolation (EPVI) recently becomes a standard treatment. However, the effectiveness of EPVI for relatively young patients remains unknown. We sought to reveal the effectiveness of EPVI in patients <50 yrs. Methods: We studied 156 consecutive patients <50 yrs (mean age 41±6 yrs, 90% males) undergoing EPVI for paroxysmal AF (PAF). All patients were followed up at the outpatient clinic without any antiarrhythmics. Results: Acute success of EPVI was achieved in all patients. Sinus rhythm (SR) was present in 101 patients (64.7%) after the initial procedure during a mean follow-up of 27±22 months. A second procedure was performed in 38/55 patients. Thirty one (81.6%) patients had PV reconnection. Eventually, among 139 patients undergoing up to second session, 127 (91.4%) patients maintained SR during mean follow-up of 33±19 months. Although AF recurrence tended to occur in patients with structural heart disease (P=0.06), no significant parameters were revealed by multivariate analysis. Conclusion: EPVI was an effective strategy for the prevention of AF in relatively young patients with PAF. Structural heart disease could be a weak predictor of AF recurrence.