Abstract 15925: Efficacy and Safety of Pulmonary Vein Isolation in Active Duty Military Members With Atrial Fibrillation

Abstract

Introduction: The efficacy and safety of pulmonary vein isolation (PVI) for atrial fibrillation (AF) in the active duty (AD) military population has not been previously reported. Hypothesis: We postulate that PVI is an efficacious and safe treatment for young AD service members with AF. Methods: AD military personnel with AF who underwent PVI from 2004 to 2019 were retrospectively analyzed in four age groups (group 1, n=26, 18 to 27 years; group 2, n=38, 28 to 37 years; group 3, n=28, 38 to 49 years; group 4, n=12, ≥50 years). Primary endpoints were (1) PVI procedural efficacy defined as no or rare AF recurrence (<6 episodes) 12 months after last PVI with or without antiarrhythmic drugs (AAD) and (2) procedure-related adverse events and complications. Results: 104 personnel (mean age 35.6+9 years, 84.6% paroxysmal AF, mean LVEF 60.2+6%, 19.2% maintained on AAD after PVI) underwent 142 PVI procedures with a mean follow up of 55.8+47 months. Procedural efficacy was attained in 96.2% of group 1, 78.9% of group 2, 75.0% of group 3, and 66.7% of group 4 (P=0.004, Figure 1). Freedom from AF was reached in 80.3% of group 1, 55.3% of group 2, 46.4% of group 3, 41.7% of group 4 (P=0.02). AADs were maintained in 11.5% of group 1, 21.0% of group 2, 14.3% of group 3, 41.7% of group 4 (P=0.144) and there was no difference in AF recurrence rates between those with AADs and those without (P=0.091). LVEF <50% trended towards being a significant predictor of AF recurrence (OR, 7; 95% CI, 0.75-65; P=0.051). Complications occurred in only 4 (3.8%) cases (pulmonary vein stenosis, cardiac tamponade, arteriovenous fistula) with no complications in the youngest group. Conclusions: This study suggests that PVI is an effective and safe therapy for younger military personnel with AF desiring to decrease their individual AF burden.