Pediatric/Adult Congenital Heart Disease -> Pediatric Cardiology D-MP08 - Pediatric and Arrhythmia & Device Management (ID 12) Moderated ePoster

D-MP08-03 - Recurrence In Pediatric Lone Atrial Fibrillation With Positive Family History (ID 1476)


Background: Adults with a positive family history have a higher incidence of lone atrial fibrillation (LAF) and a higher risk of recurrence after a first episode. Pediatric LAF is rare and little is known about the risk factors for recurrence.
Objective: We evaluated the association between family history and the risk of recurrent LAF in children in an international multicenter cohort.
Methods: This is a secondary analysis of a previously-reported retrospective 14-year cohort of pediatric LAF from 13 centers (HRS 2019). The mean age was 16.1 years (range 8-20). This study was approved by the Pediatric and Congenital Electrophysiology Society and disseminated for participation through the society membership. We considered family history positive when a relative had AF under 50 years of age. Univariate comparisons were made with an unadjusted Fisher exact test and Cox regression was used for time-to-event analysis.
Results: Only 22/243 (9%) of children with LAF had a positive family history of atrial fibrillation (AF) in a 1st degree relative. Patients with a 1st-degree family history of AF were more likely to have LAF recurrence (14/22 vs. 81/221, p=0.013). There is a trend toward earlier recurrence of AF in patients with a 1st degree family history, but numbers were likely too low for statistical significance (p=0.057, Figure). Thirteen patients (5%) had a family history of AF in a 2nd degree relative with 6/13 having recurrence (p=NS).
Conclusion: A positive family history of 1st degree relative with AF is rare in pediatric patients with LAF; however, those with a positive family history in a 1st degree relative are more likely to have clinical recurrence.