title: Significance of late recurrence of atrial fibrillation during long-term follow-up after pulmonary vein isolation.
abstract: OBJECTIVE
  Patients with paroxysmal or persistent atrial fibrillation (AF) can be treated by pulmonary vein (PV) isolation. Although the recurrence rate after the procedure is relatively high, the long-term outcomes after initially recurrence-free procedures remains unclear. We examined the rates of recurrence of AF after PV isolation.
  
  
  METHODS
  Our study included 278 consecutive patients with drug-refractory AF (mean age = 53 +/- 11 years, 228 men). PV isolation was based on the disappearance of PV potentials recorded from a circumferential catheter after segmental ostium ablation. Cavo-tricuspid isthmus lines and additional atrial lines were performed in 124 and 28 patients, respectively. Patients were monitored for a mean of 26 +/- 11 months (range 12-56). Recurrence was defined as >/= 1 episodes of symptomatic or asymptomatic AF > 1 month after the procedure.
  
  
  RESULTS
  A total of 120 (34) patients had >/= 1 recurrence of AF > 1 month after the procedure, of whom 14 (4) had a first recurrence > 6 months after the procedure. There was a significantly higher recurrence rate among patients with persistent AF.
  
  
  CONCLUSIONS
  A relatively high AF recurrence rate was observed after PV isolation. AF may recur late after the ablation procedure, though the majority of recurrences occurred within 6 months after the first procedure. There were no differences in incidence or time of occurrence of late recurrences between patients with paroxysmal versus persistent AF.
authors.affiliation: Institute of Medicine, Department of Heart Disease, Haukeland University Hospital, University of Bergen, Bergen, Norway. eivind.solheim@helsebergen.no
authors.forename: Eivind
authors.initials: E
authors.lastname: Solheim
authors.forename: Per Ivar
authors.initials: PI
authors.lastname: Hoff
authors.forename: Morten Kristian
authors.initials: MK
authors.lastname: Off
authors.forename: Ole-Jørgen
authors.initials: OJ
authors.lastname: Ohm
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D016896:Treatment Outcome