title: Catheter Ablation for "Lone" Atrial Fibrillation: Efficacy and Predictors of Recurrence.
abstract: Atrial fibrillation in otherwise healthy young patients has been termed "lone" atrial fibrillation (AF). The best treatment choice is still under discussion. The aim of this study was to report on efficacy and safety of catheter ablation.
  
  
  
  Among 855 patients referred to our center between 2011 and 2013, 76 (9%) met the diagnostic criteria for lone AF (mean age 45 ± 8 years; mean LA diameter 37 ± 4 mm; paroxysmal AF 82%; persistent AF 18%). The primary endpoint was freedom from any atrial tachycardia after the first ablation; the secondary endpoint was freedom from any atrial tachycardia after the last ablation procedure without antiarrhythmic drugs.
  
  
  
  The primary endpoint occurred in 56 patients (74%) after a mean follow-up time of 444 ± 344 days. The secondary endpoint occurred in 73 patients (96%) after a mean of 1.3 ablations/patient during a follow-up time of 459 ± 366 days. The risk of AF recurrence was not influenced by AF duration or by the type of AF (paroxysmal versus persistent). In a multivariate regression analysis smoking (P = 0.001), first degree atrioventricular block (P = 0.001), and early (< 3 months) AF recurrence (P = 0.001) were independently associated with a higher risk of AF recurrence. Major peri-procedural adverse events did not occur.
  
  
  
  Catheter ablation in young healthy patients is highly effective and safe. The outcomes are maintained during long-term follow-up irrespective of preoperative AF duration. Patients with AF recurrence were more likely to smoke, have first degree AV block and early AF recurrence.
authors.affiliation: Department of Electrophysiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Buiatti
authors.affiliation: Department of Electrophysiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Kaess
authors.affiliation: Department of Electrophysiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Reents
authors.affiliation: Department of Electrophysiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Semmler
authors.affiliation: Department of Electrophysiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Telishveska
authors.affiliation: Department of Electrophysiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Bourier
authors.affiliation: Department of Electrophysiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kornmayer
authors.affiliation: Department of Electrophysiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kottmaier
authors.affiliation: Department of Electrophysiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Hessling
authors.affiliation: Department of Electrophysiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Deisenhofer
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D054537:Atrioventricular Block / Q000150:complications; D017115:Catheter Ablation / Q000009:adverse effects; D016009:Chi-Square Distribution; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
keywords: catheter ablation; lone atrial fibrillation; predictors of recurrence; recurrence