A Clinical Study of Patients with and Without Recurrence of Paroxysmal Atrial Fibrillation After Pulmonary Vein Isolation

Patients with paroxysmal atrial fibrillation (PAF) can be treated by pulmonary vein (PV) isolation. However, the recurrence rate after this procedure is relatively high. We sought to evaluate the quality of life (QOL) of patients with PAF recurrence after PV isolation and to analyze factors related to recurrences. Seventy-two drug-refractory PAF patients (59 men, 13 women, mean age 52 ± 10) were included. PV isolation was based on the disappearance of PV potentials recorded from a Lasso catheter after segmental ostium ablation. Automatic foci were observed in 47 patients (65.3%) during the procedure. A mean of 3.1 ± 0.9 PVs was isolated. Patients were followed for a mean of 10.3 ± 5.1 months, during which 27 experienced >1 episode of PAF. QOL was scored from 0 (situation before ablation) to 10 (no episode after ablation) based on a questionnaire completed by 69 patients (95.8%). QOL was judged very good in 26 patients (none with PAF recurrences), better in 30 (15 with PAF recurrences), unchanged in 11 (10 with recurrences), and worse in 2 patients with PAF recurrences. Longer histories of PAF and a lower percentage of patients with automatic foci identified during the procedure were observed in the group with, than in the group without recurrences (P < 0.05). PV isolation improved QOL in patients with PAF, including in patients with recurrences. The length of PAF history and observation of automatic foci may be of importance for recurrences of PAF during long-term follow-up.     

Association between functional mitral regurgitation and recurrence of paroxysmal atrial fibrillation following catheter ablation: a prospective cohort study

ObjectiveThe present study aimed to investigate the effect of functional mitral regurgitation (FMR) on recurrence of paroxysmal atrial fibrillation (PAF) in patients undergoing radiofrequency catheter ablation.MethodsThis prospective cohort study comprised 107 patients with PAF. The patients were divided into the FMR and non-FMR groups. FMR was assessed by Doppler echocardiography before index ablation. All patients initially underwent circumferential pulmonary vein isolation (CPVI) and were followed up for 12 months after ablation. PAF, atrial tachycardia, or atrial flutter served as the endpoint indicator.ResultsThe median duration of PAF was 24 (3–60) months. Binary logistic univariate and multivariate analyses showed that FMR was not a risk factor for recurrence of catheter ablation for PAF (hazard ratio=0.758, 95% confidence interval: 0.191–3.004; hazard ratio=0.665, 95% confidence interval: 0.134–3.300, respectively). Kaplan–Meier analysis showed no significant difference in the recurrence rate between the groups. Fifteen (15/107, 14%) cases of PAF were triggered by the pulmonary vein. Three (3/107, 2.8%) cases of PAF were triggered by the superior vena cava.ConclusionsFMR is not an independent risk factor for predicting recurrence of catheter ablation for PAF. FMR does not affect patients undergoing radiofrequency catheter ablation for PAF.     

阵发性心房颤动患者射频消融术后心房颤动晚期复发的相关因素

目的探讨阵发性心房颤动患者射频消融术后心房颤动晚期复发的相关因素。方法收集接受三维电解剖标测系统指导下射频消融手术治疗的阵发性心房颤动患者80例,对其年龄、左房内径、术后48h内心房颤动复发及术中电复律等情况进行多因素分析,寻找心房颤动晚期复发的相关因素。结果80例患者接受82次心房颤动射频消融手术;在术后12个月的随访期内,共有25例患者心房颤动晚期复发。组间比较显示年龄、左房内径及术后48h内心房颤动复发两组之间差异有统计学意义;多元Logistic回归分析提示术后48h内心房颤动复发是阵发性心房颤动射频消融术后心房颤动晚期复发的临床预测指标（OR=3．861,95％CI=1．142～13．056,P=0．03）。结论术后48h内心房颤动复发是阵发性心房颤动射频消融术后心房颤动晚期复发的临床预测指标,术后48h内心房颤动复发患者晚期复发率增高。     

Recurrence of symptomatic atrial fibrillation after successful catheter ablation of atrioventricular accessory pathways: a multivariate regression analysis

The primary aim of this study is to investigate the factors related to the recurrence of atrial fibrillation (AF) after a successful ablation of atrioventricular accessory pathway. Thirty-seven patients with spontaneous AF (study group) were selected from 401 consecutive patients who underwent radiofrequency catheter ablation of atrioventricular accessory pathway. A multivariate regression analysis was used in order to evaluate the relationships between AF recurrence and patients' age, sex, atrial size, left ventricular function, location of accessory pathways, heart rate during atrioventricular re-entrant tachycardia and atrial vulnerability (induction of sustained AF) after a successful ablation. Atrioventricular accessory pathway was abolished in 36 of the study group patients and 351 of the control group patients. During the follow-up of 36 +/- 11 months, four patients (11.1%) from the study group experienced sustained AF. Multivariate regression analysis showed that, in patients with pre-ablation AF, older age and post-ablation atrial vulnerability were the only independent predictive factors for AF recurrence. We concluded that radiofrequency catheter ablation of atrioventricular accessory pathway greatly reduces the risk of AF in patients who had a history of symptomatic AF. Older patients and patients with inducible AF after accessory pathway ablation are at an increased risk of AF recurrence. These patients should be closely monitored after successful ablation of atrioventricular accessory pathways.     

Catheter Ablation of Electrical Storm Due to Monomorphic Ventricular Tachycardia in Patients with Nonischemic Cardiomyopathy: Acute Results and Its Effect on Long‐Term Survival

Background: Electrical storm due to recurrent ventricular tachycardia (VT) in patients with implantable cardioverter defibrillator (ICD) can adversely affect their long‐term survival. This study evaluates the efficiency of the radiofrequency catheter ablation of electrical storm due to monomorphic VT in patients with idiopathic dilated cardiomyopathy (DCM) and assesses its long‐term effects on survival. Methods and Results: Between April 2004 and October 2008, 13 consecutive patients (nine men, mean age 56.8 ± 17.8 years) with DCM and electrical storm due to monomorphic VT who had ICD underwent 17 catheter ablation procedures, including four epicardial, at our center. Acute complete success was defined as the lack of inducibility of any VT at the end of procedure during programmed right ventricular stimulation and was achieved in eight patients (61.5%). During a median follow‐up of 23 months (range 3–63 months) nine patients (69%) were alive and eight patients (61.5%) were free from VT recurrence. Among those with acute complete (n = 8) and partial (n = 5) success, seven patients (87.5%) and one patient (20%) were free from any VT recurrence and ICD therapy, respectively (P = 0.025). Among those with acute complete and partial success, seven patients (87.5%) and two patients (40%) were alive, respectively (Mantel‐Cox test P = 0.082). Among those who had an initially failed endocardial ablation (n = 8), four underwent further epicardial ablation that was completely successful in three patients (75%). Conclusion: Catheter ablation in patients with DCM and electrical storm due to monomorphic VT who had an ICD prevents further VT recurrence in 61.5% of the patients. Complete successful catheter ablation may play a protective role and was associated with reduced mortality during the follow‐up period. More aggressive ablation strategies in patients with initially failed endocardial ablation might improve the long‐term survival of these patients; however, further studies are needed to clarify this issue. (PACE 2010; 33:1504–1509)     

Use of different catheter ablation technologies for treatment of typical atrial flutter: acute results and long-term follow-up

OBJECTIVES: We report the acute success and long-term follow-up in consecutive patients undergoing catheter ablation of typical right atrial flutter (AFL) using different ablation technologies. METHODS: One hundred and two patients presenting for treatment of AFL to our laboratory were included in the study. Based on availability and physician preference, ablation was performed with either a cooled-tip catheter (39 patients, group I), an 8- or 10-mm tip catheter connected to a high-power radiofrequency (RF) generator (25 patients, group II), or a 4- or 5-mm tip catheter (38 patients, group III). Acute ablation success was achieved in all group II and group III patients. Among the 38 patients undergoing ablation with the conventional catheter tip (group I), crossover to an 8-mm tip or a cooled tip ablation catheter was required in 11 patients (29%). The mean fluoroscopy time was significantly higher in group I (54.3 +/- 26.4 minutes) when compared to group II (39.6 +/- 19.6 minutes; P < 0.05) and group III (40 +/- 16 minutes; P = 0.0.5). After a mean follow up of 20 +/- 5 months no patient in group II experienced recurrence of AFL, whereas 18.4% (7 of 38 patients; P < 0.05) in group I and 10% (4 of 39 patients; P < 0.05) in group III had recurrence of AFL. Ablation technologies designed to obtain larger size lesions appeared to be more effective in achieving acute ablation success of AFL and in limiting the long-term recurrence rate of this arrhythmia.     

Impact of corrected sinus node recovery time in predicting recurrence in patients with paroxysmal atrial fibrillation

ObjectiveAtrial fibrillation (AF) and sinus node dysfunction (SND) have common underlying pathophysiological mechanisms. As an index of SND, corrected sinus node recovery time (CSNRT) may also reflect atrial function. The aim of the present study was to determine whether CSNRT predicts AF recurrence in patients undergoing AF ablation.MethodsConsecutive patients with paroxysmal atrial fibrillation (PAF) who underwent radiofrequency catheter ablation between January 2017 and December 2018 were enrolled. Clinical data, CSNRT, and other electrophysiology indices were collected and analysed between patients with or without AF recurrence.ResultsA total of 159 patients with PAF who underwent the same radiofrequency catheter ablation procedure were enrolled, including 25 patients with SND. During the one-year follow-up period, 22 patients experienced AF recurrence. Patients with recurrence had a significantly longer CSNRT and a larger left atrial volume index (LAVI) than patients without AF recurrence. SND (CSNRT > 550 ms) and a larger LAVI were independently associated with AF recurrence after ablation. A statistically significant CSNRT cut-off value of 550 ms predicted AF recurrence with 73% sensitivity and 85% specificity.ConclusionCSNRT and LAVI are independent predictors of PAF recurrence following ablation.     

Cost Analysis of Catheter Ablation for Paroxysmal Atrial Fibrillation

WEERASOORIYA, R., et al. : Cost Analysis of Catheter Ablation for Paroxysmal Atrial Fibrillation . RF ablation for paroxysmal atrial fibrillation (PAF) is a curative treatment, which when successful, eliminates the need to take antiarrhythmic drugs, be anticoagulated, and have recurrent physician visits or hospital admissions. The authors performed a retrospective cost comparison of RF ablation versus drug therapy for PAF. The study population consisted of 118 consecutive patients with symptomatic, drug refractory PAF who underwent   1.52 ± 0.71   RF ablation procedures (range 1–4) for PAF. During a follow-up of 32 ± 15 weeks, 85 (72%) patients remained free of clinical recurrence in absence of antiarrhythmic drugs. The cost of RF ablation was calculated in the year 2001 euros on the basis of resource use. The mean cost of pharmacologic treatment prior to ablation was 1,590 euros/patient per year. The initial cost of RF ablation for PAF was 4,715 euros, then 445 euros/year. After 5 years, the cost of RF ablation was below that of ongoing medical management, and continued to diverge thereafter. RF catheter ablation may be a cost-effective alternative to long-term drug therapy in patients with symptomatic, drug refractory PAF. (PACE 2003; 26[Pt. II]:292–294)     

Primary radiofrequency ablation for incessant idiopathic ventricular tachycardia

Fascicular VT and RVOT tachycardia are sometimes difficult to induce by programmed electrical stimulation (PES), despite pharmacologic provocation. In such instances, catheter mapping is hampered and efficacy of catheter ablation is difficult to judge. The study included nine patients who presented with incessant idiopathic VT and were directly taken to the electrophysiological laboratory for RF ablation. During the same period, elective ablation was performed on 108 patients with idiopathic VT. The success rate, procedural and fluoroscopy times number of energies, and the peak temperature were evaluated and compared. Of the nine patients, seven had incessant fascicular VT and two had RVOT tachycardia. The mean VT cycle length was 356 +/- 32 ms and the earliest endocardial activation time during VT was 23.6 +/- 6 ms relative to surface QRS complexes. A fascicular potential was not seen in three of the seven patients with fascicular VT. The mean procedural time was 71 +/- 32 minutes and 144 +/- 40 minutes (P = 0.023) while the fluoroscopy time was 14.6 +/- 4.6 minutes and 30 +/- 16 minutes (P < 0.001), respectively, in the primary ablation and elective groups. The total number of RF energies delivered was 2.0 +/- 1.3 versus 7.4 +/- 5.6 (P = 0.07), respectively. The significantly increased procedural time during elective ablation was largely due to time spent in fascicular VT induction. All patients in the primary ablation group were successfully ablated and none had a recurrence. Primary ablation is a safe and effective option in patients with incessant idiopathic VT. Moreover, in fascicular VT, it is superior to elective ablation in terms of success, fluoroscopy and procedural times.     

P波离散度与阵发性房颤经导管射频消融术后复发的关系

目的：探讨P波离散度与阵发性房颤经导管射频消融术后房颤复发的关系。方法：78例初次行导管射频消融治疗的阵发性房颤患者,消融术式为电解剖标测系统加单环状标测电极指导下的环肺静脉线性消融术。测量术前体表心电图各导联的P波时限,计算P波离散度。结果：术后随访32．9±4．8个月,有效组64例,复发组14例。复发组术前的P波离散度（46．2±11．8ms）较有效组（37．4±14．2ms）大（P〈0．05）。若以40ms为界值,术前P波离散度预测术后房颤复发的敏感性为86％,特异性为59％。其他的临床及心电图指标在两组间无显著差异。结论：经导管射频消融治疗阵发性房颤的疗效肯定,复发组患者术前的P波离散度明显大于非复发组,术前P渡离散度对术后房颤的复发有一定预测价值。     

应变率成像评价孤立性阵发性房颤患者左心房主动泵血功能

目的 应用应变率成像技术定量评价孤立性阵发性房颤(paroxysmal atrial fibrillation,PAF)患者左心房(leftatrial,LA)的主动泵血功能及经导管射频消融治疗的影响.方法 选取成功接受首次经导管射频消融术并维持窦性心律半年以上的孤立性PAF患者20例作为PAF组,平均年龄(59±11...     

P波离散度预测阵发性心房颤动射频消融术后复发的价值

【目的】探讨阵发性房颤射频消融术后复发的预测因素。【方法】145例行环肺静脉导管射频消融术的阵发性房颤患者,记录术前及术后心电图,测量最大、最小P波时限,计算P波离散度。【结果】术后平均随访（6．1±0．2）个月,根据是否复发房颤分为复发组51例和未复发组94例。复发组较未复发组的术前最大P渡时限增大[（120．2±11．0）ms比（105．6±7．8）ms,P〈0．001];P波离散度明显增大[（53．6±6．2）ms比（39．9±4．7）ms,P〈0．001];两组P波最小时限及其他临床指标均无统计学差异。多因素分析示术前P波离散度≥46ms（P=0．04）和发作频率≥5次／月（P=0．01）是房颤复发的预测因素,二者预测复发的灵敏度分别是87％和86％;特异度92％和85％。【结论】术前P波离散度及房颤发作频率一定程度上可预测阵发性房颤射频消融术后的复发。     

Ganglionated plexi ablation directed by high-frequency stimulation and complex fractionated atrial electrograms for paroxysmal atrial fibrillation

Background: The effectiveness of ganglionated plexi (GP) ablation in patients with atrial fibrillation (AF) is ambiguous. Some researchers had already suggested that additional identification of complex fractionated atrial electrograms (CFAE) around the areas with a positive reaction to high‐frequency stimulation (HFS) might improve the accuracy of GP's boundaries location, then enhancing the success rate of ablation. The purpose of this study was to assess the safety and efficacy of GP ablation directed by HFS and CFAE in patients with paroxysmal AF (PAF). Methods and Results: Sixty‐two patients with PAF (age 57±8 years) underwent GP ablation. Ablation targets were the sites where vagal reflexes were evoked by HFS and additional extended ablation CFAE area around the areas where vagal reflexes were evoked. At 12 months, 71% of patients were free of symptomatic AF. At 3 months after ablation the root mean square successive differences and HF were significantly lower in patients without AF recurrence (P < 0.0001 and P = 0.004). The LF/HF ratio was significantly higher in patients without AF recurrence (P = 0.02). Conclusion: Enhanced GP ablation directed by HFS and CFAE can be safely performed and enables maintenance of sinus rhythm in the majority of patients with PAF for a 12‐month period. Denervation of the intrinsic cardiac autonomic nervous system may be the preferable target of catheter ablation of AF. (PACE 2012;XX:1–9)     

晚期慢性阻塞性肺疾病患者及晚期癌症患者的生存质量比较研究

目的比较晚期慢性阻塞性肺疾病(COPD)患者及晚期癌症患者的生存质量(Quality of life,QOL),探讨COPD患者对临终关怀的需求。方法访问COPD患者108例及癌症患者50例。采用晚期病患者生存质量量表(Quality-of-Lif Concerns in the End-of-Life Questionnaire,QOLC-E)作评估。通过统计分析,比较两组的QOL分数。结果COPD患者的基本活动程度及操作活动程度均明显低于癌症患者(t=-6.2,-4.7,P均<0.01)。而在QOLC-E的8个分类中,COPD患者在“身体不适”、“负面情绪”及“存在困扰”得分均比癌症患者低,但是“生活价值”一类却较高,差异均有显著性(P<0.05)结论研究结果显示晚期COPD患者及晚期癌症患者有相近的生存质量关注,但关注面各有不同。一方面意味临终关怀应扩展至晚期COPD患者,另一方面也显示COPD患者的诉求与晚期癌症患者不尽相同,故在发展有关服务的同时,要考虑COPD患者的独特性。     

Prospective evaluation of catheter ablation in patients with implantable cardioverter defibrillators and multiple inappropriate ICD therapies due to atrial fibrillation and type I atrial flutter

The high incidence of inappropriate therapies due to drug refractory supraventricular tachycardia remains a major unsolved problem of the ICD. Most of the inappropriate therapies for supraventricular tachycardia are caused by AF and type I atrial flutter with rapid ventricular response. The purpose of this prospective study was to determine the usefulness of AVN modulation or ablation for rapid AF and ablation of the tricuspid annulus-inferior vena cava (TA-IVC) isthmus for type I atrial flutter in ICD patients with frequent inappropriate ICD interventions. Eighteen consecutive patients were enrolled in this study. Twelve patients received a mean of 34 +/- 36 antitachycardia pacing (ATP) and 41 +/- 32 shock therapies for rapid AF during 49 +/- 39 months, and 6 patients a mean of 111 +/- 200 ATP and 11 +/- 8 shock therapies for type I atrial flutter during 52 +/- 37 months preceding ablation procedure. Modification of the AVN was successful in 10 (83%) of 12 AF patients, in 2 (17%) patients ablation of the AVN was performed. A complete TA-IVC isthmus block was achieved in 5 (83%) of 6 atrial flutter patients. Three (25%) AF patients had 11 +/- 24 recurrences of ATP and 0.4 +/- 1.1 shock therapies for rapid AF during 15 +/- 7 months. None of the atrial flutter patients had recurrences of inappropriate therapies for type I atrial flutter during 14 +/- 8 months, but two (33%) patients had inappropriate ICD therapies for type II atrial flutter or rapid AF. There was an overall mean incidence of 18 +/- 22 inappropriate ICD therapies per 6 months before and 4 +/- 9 per 6 months after the ablation procedure (P < 0.05). In conclusion, radiofrequency catheter modification or ablation of the AVN for rapid AF and ablation for atrial flutter type I are demonstrated to be highly effective in the majority of ICD patients with drug refractory multiple inappropriate ICD therapies.     

Catheter ablation approach on the right side only for paroxysmal atrial fibrillation therapy: long-term results

We report the long-term follow-up of a right side only catheter ablation approach for paroxysmal AF. Eighteen patients with AF refractory to drugs entered the study. Ablation was attempted in the right atrium only by creating linear lesions based on a specific design including from two to four linear lesions. Induction of AF was attempted before ablation and after placement of the lesions. A septal lesion was performed in nine patients. In ten patients atrial defibrillation thresholds (ADFTs) before ablation and following creation of the linear lesions were compared. After a mean follow-up of 22 +/- 11 months, seven patients had recurrence of AF, and another nine patients experienced atrial flutter or atrial tachycardia. Five patients remained in sinus rhythm without medications and four required the use of drugs. Three patients had sporadic AF and six were in chronic AF. The recurrence rate was similar in patients with and without the septal lesion. However, a cure with right side ablation appeared to be predicted by the presence of disorganized and earlier activity in the high right atrium and crista terminalis. Linear lesions in the right atrium were associated with a lower ADFT (pre 2.6 +/- 04 J vs post 1.7 +/- 0.6 J). In conclusion, in a small number of patients, control of AF can be obtained with a right side only approach. Certain activation patterns may identify patients suitable to this approach. No specific lesion pattern appeared more effective. Right atrial linear lesions resulted in lower ADFT.     

Reversal of tachycardia induced cardiomyopathy following ablation of repetitive monomorphic right ventricular outflow tract tachycardia

Radiofrequency catheter ablation was performed in four adults with myocardial dysfunction related to repetitive monomorphic ventricular tachycardia (RMVT) originating in the right ventricular outflow tract. Serial echocardiographic assessment of left ventricular function before and after radiofrequency catheter ablation of RMVT showed complete reversal of left ventricular dysfunction without arrhythmia recurrence during 31+/-28 months follow-up.     

The results of radiofrequency catheter ablation of supraventricular tachycardia in children

BACKGROUNDS: Radiofrequency (RF) catheter ablation represents a major advance in the management of children with cardiac arrhythmias and has rapidly become the standard of care for the first-ling therapy of supraventricular tachycardias (SVTs). The purpose of this study was to investigate the results of the RF catheter ablation of SVTs in pediatric patients. METHODS: From December 1989 to August 2005, a total of 228 pediatric patients (age: 9 +/- 7 years, range: 5-18 years; male:female = 117:111) with clinically documented SVT underwent an electrophysiologic study and RF catheter ablation at our institution. RESULTS: The arrhythmias included atrioventricular reentrant tachycardia (AVRT; n = 140, 61%), atrioventricular nodal reentrant tachycardia (AVNRT; n = 66, 29%), atrial tachycardia (AT; n = 11, 5%), and atrial flutter (AFL; n = 11, 5%). The success rate of the RF catheter ablation was 92% for AVRT, 97% for AVNRT, 82% for AT, and 91% for AFL, respectively. Procedure-related complications were infrequent (8.7%; major complications: high grade AV block (2/231, 0.9%); minor complications: first degree AV block (6/231, 2.6%), reversible brachial plexus injury (2/231, 0.9%), and local hematomas or bruises (10/231, 4.3%)). The recurrence rate was 4.7% (10/212) during a follow-up period of 86 +/- 38 months (0.5-185 months). CONCLUSIONS: The RF catheter ablation was a safe and effective method to manage children with paroxysmal and incessant tachycardia. The substrates of the arrhythmias differed between the pediatric and adult patients. However, the success rate of the ablation, complications, and recurrence during childhood were similar to those of adults.     

Single Physician Approach to Radiofrequency Catheter Ahlation in Patients with Supraventricuiar Tachycardia

The minimal requirements for safe and effective performance of catheter ablation using radio/requency current are still unclear. To determine the feasibility and safety of single physician approach to catheter ablation of supraventricuiar tachycardia substrate using radio-frequency energy, the results of the ablation procedure in 52 consecutive patients were evaluated. The procedures were performed during 1 year by the same physician and nurse. Twenty-one patients had selective atrioventricuJar (AV) nodal pathway ablation and 31 patients had accessory AV pathway ablation. Forty-eight patients (89%) had the diagnostic and the ablative procedure during the same electrophysiological test. In the 21 patients with AV nodal reentrant tachycardia, all had successful selective ablation of the fast (13) or the slow (8) pathways. Eight patients had recurrence of the clinical tachycardia and had a successful reablation. No patient developed complete AV block or other significant complications. The mean fluoroscopy time during the procedure was 16.0 ± 8.6 minutes. In the eight patients with Wolff-Parkinson-White syndrome, all concealed accessory pathways were successfully ablated with a mean fluoroscopy time of 30.0 ± 27.9 minutes. Two patients had recurrence of the conduction through the accessory pathway and had a successful reablation. Eighteen of 19 patients with a single overt accessory pathway had successful ablation, with a fluoroscopy time of 22.7 ± 20.6 minutes. Three patients had an early recurrence of the conduction through the accessory pathway, reablation was successful in two of them. Ten accessory pathways were ablated in four patients with multiple pathways during nine procedures. Only two patients developed minor peripheral vascular complications. Radiofrequency ablation of supraventricular tachycardia substrates may be performed effectively and safely by a small team just of one physician and one nurse.     

Predictive value of early atrial tachyarrhythmias recurrence after circumferential anatomical pulmonary vein ablation

OBJECTIVE: Radiofrequency (RF) ablation at the ostia of the pulmonary veins (PVs) to cure atrial fibrillation (AF) is often followed by early AF recurrence. The aims of this study were to determine the rate of early atrial tachyarrhythmia as recurrence after circumferential anatomical PV ablation; to evaluate whether the early recurrence of atrial tachyarrhythmias correlates with the long-term outcome of ablation; and to identify the predictors of early atrial tachyarrhythmias relapse. METHODS: We studied 143 consecutive patients who underwent circumferential anatomical PV ablation. We defined early atrial tachyarrhythmias relapse as the recurrence of atrial tachyarrhythmias during the first 3 months after RF ablation. RESULTS: After a mean follow-up of 18.7 +/- 7.2 months, 102/143 patients (71%) were deemed responders to ablation. Atrial tachyarrhythmias relapsed during the first 3 months of follow-up in 65/143 (46%) patients. Patients without early atrial tachyarrhythmias relapse had a higher probability of long-term clinical success than patients with early atrial tachyarrhythmias relapse (95% vs 43%, P < 0.0001). However, patients who relapsed within the first month had 45.5% probability of long-term clinical success. On multivariate analysis, the presence of structural heart disease and the lack of a successful anatomical ablation of all targeted PV were significantly and independently correlated with early atrial tachyarrhythmias relapse. CONCLUSION: A delayed cure may be expected in almost 50% of patients in whom atrial tachyarrhythmias relapses within the first month after circumferential anatomical PV ablation. The presence of structural heart disease and the lack of a successful anatomical ablation of all targeted PV predict early atrial tachyarrhythmias recurrence.