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June 27, 2026EP EuropaceOpen Access

High-burden PVCs after AF ablation linked to greater heart failure hospitalization but similar AF-free survival.

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Why the study?

Although a high burden of premature ventricular contractions is associated with new-onset AF, the clinical importance of high PVC burden after AF ablation remains unknown.

Does high-burden PVC after AF ablation increase the risk of AF/AT recurrence or heart failure hospitalization in patients undergoing AF ablation?

Population

696 patients with a 24-hour Holter ECG after AF ablation

Comparison

High-burden PVC (≥ 1%) vs low-burden PVC (< 1%)

Design

Retrospective cohort study

Key result

High-burden PVC after AF ablation was not associated with 3-year AF/AT-free survival (79.0% vs 71.4%, P=0.15), but increased heart failure hospitalization (6.1% vs 2.5%, P=0.002).

Authors

SNS NishiwakiTIT InoueAMA Morinaga

Discussion

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Overview

High PVC burden does not worsen post-ablation AF outcomes; leaves open its prognostic role in prospective trials.

Key Points

  • This study aims to evaluate the impact of high-burden premature ventricular contractions on clinical outcomes after atrial fibrillation ablation.
  • Retrospective investigation of 1226 patients who underwent AF ablation between January 2016 and December 2019.
  • Population consisted of 696 patients with a 24-hour Holter electrocardiogram post-ablation, split into high-burden (≥ 1%) and low-burden (< 1%) PVC groups.
  • Outcome measures compared between the two PVC groups.
  • Three-year AF/atrial tachycardia-free survival rates were 79.0% for high-burden PVC and 71.4% for low-burden PVC (P=0.15).
  • The incidence of hospitalization for heart failure was significantly higher in the high-burden PVC group (6.1% vs. 2.5%, P=0.002).
  • No significant difference in AF/AT-free survival rate among PVC origins (P=0.53).

Study Design

Type

Cohort (n=696)

Structured PICO

Does high-burden PVC after AF ablation increase the risk of AF/AT recurrence or heart failure hospitalization in patients undergoing AF ablation?

P
Population
696 patients who underwent atrial fibrillation ablation and had a 24-hour Holter ECG, followed for 3 years.
E
Exposure
High-burden premature ventricular contractions (PVCs) (≥ 1%) on 24-hour Holter ECG after AF ablation
C
Comparator
Low-burden premature ventricular contractions (PVCs) (< 1%) on 24-hour Holter ECG after AF ablation
O
Outcome
Three-year AF/atrial tachycardia (AT)-free survival rate and three-year incidence of hospitalization for heart failurehard clinical

Main Result

Absolute Event Rate: 79% vs 71.4%

p-value: p=0.15

High-burden PVCs after AF ablation are associated with an increased risk of heart failure hospitalization, though not with AF/AT recurrence.

Cite This Study

Nishiwaki et al. (2026) conducted a cohort in Atrial fibrillation (n=696). High-burden premature ventricular contractions (≥ 1%) vs. Low-burden premature ventricular contractions (< 1%) was evaluated on Three-year AF/atrial tachycardia (AT)-free survival rate (p=0.15). High-burden PVC after AF ablation was not associated with 3-year AF/AT-free survival (79.0% vs 71.4%, P=0.15), but increased heart failure hospitalization (6.1% vs 2.5%, P=0.002).

synapsesocial.com/papers/6a3f97bb125782b61d8658d0https://doi.org/10.1093/europace/euag105.188
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