Efficacy and risk of atrial fibrillation ablation before 45 years of age

Peter Leong-Sit, Erica Zado, David J. Callans, Fermin Garcia, David Lin, Sanjay Dixit, Rupa Bala, Michael P. Riley, Mathew D. Hutchinson, Joshua Cooper, Edward P. Gerstenfeld, Francis E. Marchlinski

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65 Scopus citations


Background-Young patients with atrial fibrillation (AF) tend to be more symptomatic and less willing to take long-term medications, yet catheter ablation remains recommended as second-line therapy for AF regardless of age. This study seeks to characterize the effectiveness and risk of AF ablation in the young. Methods and Results-Consecutive (n=1548) patients who underwent 2038 AF ablation procedures were included. Major procedural complications and efficacy were analyzed on the basis of age at the initial procedure: <45 years (group 1), 45 to 54 years (group 2), 55 to 64 years (group 3), and =65 years (group 4). AF control was defined as no or rare AF on or off antiarrhythmic drugs. The primary outcome of AF control was similar in all groups; it was achieved in 87% in group 1, 88% in group 2, 88% in group 3, and 82% in group 4 (P=0.06). However, more group 1 patients demonstrated freedom from AF off antiarrhythmic drugs (76%) compared with group 2 at 68%, group 3 at 65%, and group 4 at 53% (P<0.001). There were no major complications in group 1, 10 (1.7%) in group 2, 14 (1.4%) in group 3, and 10 (2.6%) in group 4 (P=0.01). Conclusions-In patients younger than 45 years, there is a lower major complication rate and a comparable efficacy rate, with a greater chance of being AF free without antiarrhythmic drugs. These findings suggest that it may be appropriate to consider ablative therapy as first-line therapy in this age group.

Original languageEnglish (US)
Pages (from-to)452-457
Number of pages6
JournalCirculation: Arrhythmia and Electrophysiology
Issue number5
StatePublished - Oct 1 2010


  • Ablation
  • Arrhythmia
  • Catheter ablation
  • Complications
  • Tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Leong-Sit, P., Zado, E., Callans, D. J., Garcia, F., Lin, D., Dixit, S., Bala, R., Riley, M. P., Hutchinson, M. D., Cooper, J., Gerstenfeld, E. P., & Marchlinski, F. E. (2010). Efficacy and risk of atrial fibrillation ablation before 45 years of age. Circulation: Arrhythmia and Electrophysiology, 3(5), 452-457. https://doi.org/10.1161/CIRCEP.110.938860