Genetic testing provided clinically actionable insights for a subset of patients with early-onset AF, according to a study published in the European Heart Journal. The precision medicine cohort included 264 adults (median age 47 years) referred for evaluation after AF diagnosis before age 60.

Among 242 patients (92%) who underwent genetic testing using a cardiomyopathy and arrhythmia gene panel, 20% had pathogenic or likely pathogenic variants. Predictors of a positive genetic result included cardiomyopathy, infranodal conduction disease, and elevated T1 or late gadolinium enhancement on cardiac magnetic resonance imaging (all P < .05).

Genetic results influenced clinical management in more than half of genotype-positive patients, leading to implantable cardioverter-defibrillator placement in seven and initiation of disease-modifying therapy in 16. Obstructive sleep apnea and a normal 12-lead ECG predicted negative testing outcomes.

These findings demonstrate the diagnostic and therapeutic utility of genetic evaluation in early-onset AF and support integration of precision medicine into clinical practice for atrial arrhythmia management.