Early recurrence of atrial arrhythmias after PVI-PFA occurred in 38% of patients, all of whom subsequently experienced late recurrence, though the median arrhythmia burden remained low (0.3%).
Cohort (n=52)
No
Does early recurrence of atrial arrhythmias predict late recurrence after pulmonary vein isolation using pulsed field ablation in patients with paroxysmal atrial fibrillation?
Early recurrence of atrial arrhythmias after pulsed field ablation strongly predicts late recurrence, suggesting it may serve as a reliable indicator of procedure failure.
BACKGROUND Early recurrences of atrial arrhythmias are common after radiofrequency (RF) and cryoablation of atrial fibrillation (AF) and do not necessarily indicate treatment failure. Since tissue injury and inflammation are less extensive with pulsed field ablation (PFA), early recurrences may serve as more reliable indicators of procedure failure. OBJECTIVE To characterize types of atrial arrhythmias recurring after index pulmonary vein isolation using PFA (PVI-PFA) in patients with paroxysmal AF and to evaluate their occurrence rate and association with long-term clinical outcomes using implantable loop recorder (ILR). METHODS This single-center, prospective study enrolled consecutive patients older than 18 years undergoing single shot PFA for symptomatic paroxysmal AF. Concomitant PVI-PFA and ILR implantation were performed to monitor atrial fibrillation/atrial flutter/atrial tachycardia (AF/AFL/AT) recurrence. ILR were interrogated at 1, 3, 6 and 12 months post-procedure, with subsequent follow-up visits every 6 months until the last patient concluded 1-year follow-up. RESULTS The median follow-up period was 24 months (IQR; min-max = 14-30; 12-36) months. Among 52 patients, 34 (65%) experienced AF/AFL/AT recurrence during the observation period. Early recurrence of atrial arrhythmias was observed in 20 patients (38%), all of whom experienced late recurrence as well. The overall arrhythmia burden in the entire cohort was low (0.01%), while the median arrhythmia burden among patients with recurrence was 0.3%. CONCLUSION Early AF/AFL/AT recurrence was a significant risk factor for late atrial arrhythmia recurrence after single-shot PVI-PFA. Although a significant portion of the participants experienced atrial arrhythmia recurrence, the overall arrhythmia burden in this subgroup remained low.
Lisica et al. (Sun,) conducted a cohort in paroxysmal atrial fibrillation (n=52). Pulmonary vein isolation using pulsed field ablation (PVI-PFA) was evaluated on AF/AFL/AT recurrence. Early recurrence of atrial arrhythmias after PVI-PFA occurred in 38% of patients, all of whom subsequently experienced late recurrence, though the median arrhythmia burden remained low (0.3%).