Early recurrences after paroxysmal atrial fibrillation ablation: when is the proper timing for reablation?
BACKGROUND
Early recurrences (ERs) within 1 month after paroxysmal atrial fibrillation (AF) ablation are common and may subside in a considerable proportion of patients. Although late reablation after 3 months is recommended, the proper timing for reablation remains undetermined.


RESULTS
One hundred and seventeen (31.2%) from the pool of 375 patients experienced ERs at 7.5 ± 5.5 days postablation. They were allocated into two groups randomly: early reablation group (ERe+) (n = 57) and nonearly reablation group (ERe-) (n = 60). Forty patients (70.2%) in ERe+ group underwent early reablation at 28.1 ± 2.7 days postablation. Forty patients (66.7%) in ERe- group underwent late reablation at 98.2 ± 5.2 days postablation. The proportion of reablation was comparable (P = 0.68). ERs subsided in 17 (29.8%) in ERe+ group and in 20 (33.3%) in ERe- group. In ERe+ group, PV reconnection in 36 (80.0%), non-PV foci in six (10.5%), and right or left atrial flutter in five (8.8%) was abolished by ablation. In ERe- group, pulmonary vein (PV) reconnection in 29 (72.5%), non-PV foci in eight (13.3%), and right or left atrial flutter in eight (13.3%) was ablated successfully. The proportion of PV reconnection, nonfoci, and atrial flutter was comparable, P = 0.45, 0.64, and 0.56, respectively. At the end of 16.5 ± 2.0 (ERe+ group) and 15.2 ± 2.6 (ERe- group) months' follow-up, 47 (82.5%) in ERe+ group and 51 (85%) in ERe- group were free of atrial tachyarrhythmias, P = 0.70.


CONCLUSIONS
Compared with reablation 2 months later after initial ablation, early reablation at ≈1 month had similar clinical effectiveness. The proper timing for reablation can be set at ≈1 month after initial paroxysmal AF ablation.
Department of Cardiology, Shanghai Chest Hospital affiliated with Shanghai Jiaotong University, Shanghai, P R China.
Xinhua
X
Wang
Xu
X
Liu
Haifeng
H
Shi
Hongwei
H
Tan
Weifeng
W
Jiang
Yuanlong
Y
Wang
Guoshu
G
Yang
Li
L
Zhou
D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000517:prevention & control / Q000601:surgery*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012086:Reoperation / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention; D016896:Treatment Outcome