title: Catheter ablation of atrial fibrillation in the young: insights from the German Ablation Registry.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Cardioangiologisches Centrum Bethanien Medizinische Klinik III Markus Krankenhaus, Wilhelm Epstein Str, 260431, Frankfurt am Main, Germany. j.chun@ccb.de
authors.forename: K R Julian
authors.initials: KR
authors.lastname: Chun
authors.forename: Boris
authors.initials: B
authors.lastname: Schmidt
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.forename: Dietrich
authors.initials: D
authors.lastname: Andresen
authors.forename: Stefan
authors.initials: S
authors.lastname: Willems
authors.forename: Stefan G
authors.initials: SG
authors.lastname: Spitzer
authors.forename: Ellen
authors.initials: E
authors.lastname: Hoffmann
authors.forename: Burghard
authors.initials: B
authors.lastname: Schumacher
authors.forename: Lars
authors.initials: L
authors.lastname: Eckardt
authors.forename: Karlheinz
authors.initials: K
authors.lastname: Seidl
authors.forename: Claus
authors.initials: C
authors.lastname: Jünger
authors.forename: Martin
authors.initials: M
authors.lastname: Horack
authors.forename: Johannes
authors.initials: J
authors.lastname: Brachmann
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D005858:Germany; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D012042:Registries; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome