200: Safety and Effectiveness of Catheter Ablation of Atrial Fibrillation Before 30 Years of Age

Catheter ablation has emerged as a realistic therapeutic option for symptomatic atrial fibrillation (AF). Young patients with AF are often more symptomatic and long-term taking medication is very demanding for their daily life. The aim of our study is to describe the safety and the long-term effectiveness of catheter ablation of AF in patients under 30 years of age. Twenty five consecutive patients < 30 years old (mean age: 26±3; 16-29) with paroxysmal (13 pts, 52%) or persistent AF (12 pts, 48%, AF duration 40±24 months) underwent catheter ablation of symptomatic atrial fibrillation refractory to at least one antiarrythmic drug (AAD), in our center. Only 3 patients had structural heart disease (hypertrophic cardiomyopathy). Patients were hospitalized and monitored at 3, 6 and 12 months, every 6 months thereafter and at the end of the follow up. Mean radio frequency duration was 51±29 min (39±14 for PAF and 65±40 for PsAF) for total procedure time of 176±91 min (128±55 for PAF and 224±100 for PsAF) and a fluoroscopic time of 52±33 min (38±20 for PAF and 62±36 for PsAF). In all procedures, no major complication occurred. After a mean follow up of 54 months ± 29; 21/25 (84%) patients remained arrhythmia-free (92% for PAF and 76% for PsAF) after a mean of 1.6 procedure per patient. 19 of the 21 arrhythmia free patients were also AAD free. Only 3 patients of these 21 patients were treated with warfarin. These finding suggest that catheter ablation of AF in patients under 30 years of age is safe, with good clinical long term outcome. Catheter ablation of AF can be first-line therapy in young people.