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.