Dr Amitai Segev (Sheba Medical Centre, Israel) presented a study that retrospectively evaluated patients aged ≤45 years, who were admitted to the internal and cardiology wards between January 2009 and December 2019 at a large tertiary centre [1]. The purpose of the study was to identify the determinants of AF in this population in order to help direct timely diagnosis, appropriate follow-up, and management.
The study cohort consisted of 16,432 patients. Clinical, electrocardiographic, and echocardiographic data were collected and compared among patients with and without AF at baseline. Baseline characteristics of patients with AF (n=366) were statistically significantly different from those without AF (n=16,066) in a variety of parameters strongly and independently associated with young-onset AF, such as age, male gender, obesity, and heart failure. A subgroup of patients with no AF at baseline were followed for development of new-onset AF (NOAF).
A subset of 10,691 patients without AF at baseline was followed for a median of 41.5 months, during which 85 patients developed NOAF (equivalent to 0.5%/year). Independent predictors of NOAF were increased age, hypertension, heart failure, and right and left bundle branch block.
In summary, young-onset AF is characterised by a specific clinical profile of comorbidities and ECG abnormalities. Subjects at high risk for the development of NOAF can be identified, and more intense follow up of selected individuals may result in early diagnosis and intervention.
- Segev A. Atrial fibrillation in the young: clinical characteristics, predictors of new onset and outcomes. 2021 EHRA Congress, 23-25 April.
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