Results
Characteristics of included studies
Our search approach initially turned up 444 potentially pertinent studies. The review of the title and abstract determined that a total of 388 of these were excluded (Figure 1). After a thorough full-text review, 40 of the remaining studies were disregarded due to the following reasons: surgical epicardial ablation (n = 5), duplicate studies (n = 22), reviews (n = 7), lack of outcomes of interest (n = 4), and insufficient dates for analysis (n=2). 6 papers published between 2010 and 2021 that satisfied our eligibility criteria and reported the intended clinical outcomes of catheter ablation in young patients compared to older patients were found after thorough review.
The baseline characteristics of the included studies are shown in Table 1. 1001 (10.0%) of the 9982 patients who had catheter ablation for AF were younger patients. In four studies, the age of the young group was defined as less than 45 years old, and in the other two studies, the average age of the young group was 30 years old. Old group have a higher history of stroke, DM, heart failure in the past, as well as to have larger LA diameters, and higher CHA2DS2-VASc score.
The quantitative synthesis of independence from AF/AT recurrence in younger group vs old group included 6 research.These investigations showed heterogeneity (P= 0.02; I2 = 80%) pooled research found that at the year follow-up, younger patients had a significantly lower rate of AF/AT recurrence than old patients(OR=0.58, 95% CI 0.36,0.92, Figure 2).
Stroke/transient ischaemic attack
Three studies were included in the analysis of stroke/TIA. There
were 29 (0.34%) events among 8429 participants. Pooled analysis showed that in the young patient was associated with a similar risk of stroke/TIA compared with old patients (OR: 0.25, 95% CI: 0.05–1.41; P =0.12; Figure 3).
Pericardial effusion/tamponade
Four studies were included in the analysis of Pericardial effusion/ tamponade. There were 83 (0.90%) events among 8305 participants. Pooled analysis showed that there was no significant difference between in the young patient and old patients (OR: 0.61, 95% CI: 0.29–1.27; P =0.18; Figure 4).
Hematoma
Four studies were included in the analysis of hematoma,including hematoma requiring transfusion,large groin hematoma, There were 18 events among 8305 participants. Pooled analysis showed that there was no significant difference between in the younger patient and old patients (OR: 1.87, 95% CI: 0.62–5.63; P =0.27; Figure 5).
Sensitivity, subgroup, and metaregression analysis
Sensitivity analysis (using the single-study-removed method) showed good stability in the clinical endpoints of freedom from AF/AT recurrence. For the primary endpoints, meta-regression indicated that no significant correlation between the preselected covariates and the overall treatment effect of catheter ablation was observed.Funnel plot indicated that there is no significant bias between all articles included in our meta-analysis, as shown in supplement Figure 1.