Long-term efficacy of delayed cure after circumferential pulmonary vein ablation of atrial fibrillation

INTRODUCTION: The reliability of delayed cure of early recurrence of atrial fibrillation (ERAF) is still undetermined. Furthermore, the predictors of recurrence after delayed cure of ERAF are less investigated in depth. AIMS OF THE STUDY: The purpose of this study was to investigate the long-term efficacy of delayed cure of ERAF after catheter ablation of AF and explore the he predictors of recurrence after delayed cure of ERAF. METHODS AND RESULTS: We prospectively studied 300 consecutive patients with atrial fibrillation (AF) who were referred for circumferential pulmonary vein ablation (CPVA). After a follow-up of 19.2 +/- 4.1months, of the 87 patients with early recurrence of AF 41 achieved delayed cure, 11 of them reoccurred AF subsequently. Univariate analysis showed that persistent AF, absence of pulmonary vein (PV) isolation and external cardioversion were related to reoccurrence after delayed cure. Logistic regression analysis identified only absence of PV isolation as a predictor of recurrent AF after delayed cure. CONCLUSIONS: Delayed cure after CPVA is relatively common and its efficacy at long-term follow-up is reasonably consistent. However, in patients without PV isolation, delayed cure is unstable and the risk of late recurrence is increased.