The higher recurrence rate after catheter ablation in younger patients with atrial fibrillation suggesting different pathophysiology

Ahn, Hyo‐Won; Cha, Myung‐Jin; Oh, Seil; Lee, So‐Ryoung; Choi, Eue‐Keun; Han, Seongwook; Nam, Gi-Byung; Choi, Jong‐Il; Pak, Hui-Nam; Oh, Il-Young; Shin, Dong‐Gu; On, Young Keun; Park, Sang Weon; Kim, Young-Hoon; Oh, Seil

doi:10.1007/s10840-022-01461-0

Cited by 1 publication

(1 citation statement)

References 39 publications

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“…Indeed, a randomized, controlled trial has shown that in patients free from AF at the end of ablation, the continued use of previously ineffective AADs significantly reduced the recurrence of AF-a finding that AADs and ablation may have additive or being complementary [106]. On the other hand, extended interventional procedures targeting non-pulmonary vein triggers (such as ganglionated plexus block, antrum disconnection, and complex fractionated atrial electrograms isolation) represent additional effort to maintain sinus rhythm after catheter ablation in young AF patients compared to the old [107]. Finally, more emphasis on lifestyle modification, early interruption of AF, or performing non-AF substrate study could be possible therapeutic options.…”

Section: Ablative Strategiesmentioning

confidence: 99%

Pathophysiology of Atrial Fibrillation and Approach to Therapy in Subjects Less than 60 Years Old

Curcio,

Scalise,

Indolfi

2024

IJMS

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Atrial fibrillation (AF) is an arrhythmia that affects the left atrium, cardiac function, and the patients’ survival rate. Due to empowered diagnostics, it has become increasingly recognized among young individuals as well, in whom it is influenced by a complex interplay of autoimmune, inflammatory, and electrophysiological mechanisms. Deepening our understanding of these mechanisms could contribute to improving AF management and treatment. Inflammation is a complexly regulated process, with interactions among various immune cell types, signaling molecules, and complement components. Addressing circulating antibodies and designing specific autoantibodies are promising therapeutic options. In cardiomyopathies or channelopathies, the first manifestation could be paroxysmal AF; persistent forms tend not to respond to antiarrhythmic drugs in these conditions. Further research, both in vitro and in vivo, on the use of genomic biotechnology could lead to new therapeutic approaches. Additional triggers that can be encountered in AF patients below 60 years of age are systemic hypertension, overweight, diabetes, and alcohol abuse. The aims of this review are to briefly report evidence from basic science and results of clinical studies that might explain the juvenile burden of the most encountered sustained supraventricular tachyarrhythmias in the general population.

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Section: Ablative Strategiesmentioning

confidence: 99%