Atrial fibrillation in young patients

Abstract

Atrial fibrillation (AF) is the most frequent arrhythmia worldwide. While mostly seen in elderly, it can also affect young adults (≤ 45 years of age), older adolescent, and children. Areas covered: The aim of this review is to provide an overview of the current management of AF in young patients. Specific issues arise over diagnostic workup as well as antiarrhythmic and anticoagulation therapies. The future management and diagnostic strategies are also discussed. Expert commentary: Management of AF in the young adult is largely extrapolated from adult studies and guidelines. In this population, AF could reveal a genetic pathology (e.g. Brugada, Long QT or Short QT syndromes) or be the initial presentation of a cardiomyopathy. Therefore, thorough workup in the young population to eliminate potential malignant pathology.

Fulminant myocarditis and atrial fibrillation in child with acute COVID-19

“…While ventricular dysfunction and the whole gamut of arrhythmias have been reported in adults with acute COVID-19 [ 1 ], pediatric patients have either been asymptomatic or have mostly manifested with mild respiratory illness [ 2 ]. Rare pediatric patients with COVID-19 have presented with ventricular dysfunction [ 3 ]; however, arrhythmias such as AFib, which are exceedingly rare in otherwise healthy children, have not been reported in children with acute COVID-19 [ [4] , [5] , [6] , [7] , [8] , [9] ].…”

“…AFib in young patients (<18 yrs) is exceedingly rare and is usually associated with alcohol or drug abuse [ 5 ], an inherited channelopathy such as Brugada syndrome, long QT syndrome, short QT syndrome or a cardiomyopathy [ 6 , 7 ]. Familial AFib has also been reported in the pediatric population [ 8 ].…”

Young-onset atrial fibrillation: Sex differences in clinical profile, progression rate and cardiovascular outcome

“…In our prospective cohort, one out of four patients were women. AF is a rare disease in the young, and the probable misnomer ‘lone AF’ remains a diagnosis of exclusion [8], [9], [10]. Careful evaluation for cardiovascular risk factors should therefore be performed.…”

“…Data regarding underlying diseases in young patients with AF is rare, and may be different compared to older patients [8]. One would ideally like to identify underlying comorbidities early on in order to potentially prevent disease progression [9].…”

“…One would ideally like to identify underlying comorbidities early on in order to potentially prevent disease progression [9]. It has been shown that familial history of AF is often present in young-onset AF [8]. Whether there are risk factors that specifically affect women or men in young-onset AF has not yet been reported.…”