title: Incidence and time course of early recovery of pulmonary vein conduction after catheter ablation of atrial fibrillation.
abstract: BACKGROUND
  Although it is well recognized that recovery of pulmonary vein (PV) conduction is common among patients who fail atrial fibrillation (AF) ablation, little is known about the precise time course of recurrence.
  
  
  OBJECTIVE
  To determine the incidence and time course of early recurrence of conduction after PV isolation during AF ablation.
  
  
  METHODS
  The patient population was composed of 14 consecutive patients (9 men [64%]; age 56 +/- 7 years) with AF who underwent radiofrequency catheter ablation via circumferential ablation with PV isolation, determined by a circular mapping catheter. After successful isolation of the PVs, repeat circular electrode recordings from each PV were obtained at 30 and 60 minutes.
  
  
  RESULTS
  After complete isolation of all PVs, early PV recurrence was observed in 13 (93%) patients and 26 veins (50%). Seventeen veins (33%) showed a first recurrence at 30 minutes, while nine veins (17%) showed a first recurrence at 60 minutes.
  
  
  CONCLUSIONS
  The results reveal an extremely high rate of early recurrence of PV conduction following AF ablation. It is particularly notable that about one-fifth of the veins remained isolated at 30 minutes, but subsequently developed recurrence between 30 and 60 minutes. Of the veins that showed early recurrence, one-third developed a first recurrence at 60 minutes. These findings suggest that AF ablation procedures should incorporate a 60-minute waiting period after initial isolation in order to detect early recurrence of conduction.
authors: Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-0409, USA.
authors: Aamir
authors: A
authors: Cheema
authors: Jun
authors: J
authors: Dong
authors: Darshan
authors: D
authors: Dalal
authors: Joseph E
authors: JE
authors: Marine
authors: Charles A
authors: CA
authors: Henrikson
authors: David
authors: D
authors: Spragg
authors: Alan
authors: A
authors: Cheng
authors: Saman
authors: S
authors: Nazarian
authors: Kenneth
authors: K
authors: Bilchick
authors: Sunil
authors: S
authors: Sinha
authors: Daniel
authors: D
authors: Scherr
authors: Ibrahim
authors: I
authors: Almasry
authors: Henry
authors: H
authors: Halperin
authors: Ronald
authors: R
authors: Berger
authors: Hugh
authors: H
authors: Calkins
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000503:physiopathology*; D020127:Recovery of Function; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome