title: Characteristics and significance of very early recurrence of atrial fibrillation after catheter ablation.
abstract: BACKGROUND
  Early restoration of sinus rhythm following ablation of atrial fibrillation (AF) facilitates reverse atrial remodeling and improves the long-term outcome. The purpose of this study was to determine the predictors and outcome in patients with very early AF recurrences (< 2 days).
  
  
  RESULTS
  Ablation was performed in 339 consecutive AF patients (paroxysmal AF = 262). Biatrial voltage was mapped during sinus rhythm. If recurrent AF occurred within 2 days following the ablation, electrical cardioversion was performed to restore sinus rhythm. Very early recurrences of AF occurred in 39 (15%) patients with paroxysmal AF and 26 (34%) with nonparoxysmal AF. Patients with very early recurrence had a higher incidence of nonparoxysmal AF (40% vs 18.6%, P< 0.001), requirement of electrical cardioversion during procedure, larger left atrial (LA) diameter (43 ± 7 vs 39 ± 6 mm, P< 0.001), lower left ventricular ejection fraction (54 ± 10% vs 59 ± 7, P< 0.001), longer procedural time, and lower LA voltage (1.5 ± 0.7 vs 1.9 ± 0.8 mV, P< 0.001). A multivariate analysis revealed that the independent predictors of a very early recurrence were a longer procedural time and lower LA voltage. During a follow-up of 13 ± 5 months, a very early recurrence did not predict the long-term outcome of a single procedure recurrence in the patients with paroxysmal AF, but was associated with a late recurrence in the nonparoxysmal AF patients.
  
  
  CONCLUSIONS
  Very early recurrence occurred in patients with paroxysmal AF is not associated with long-term recurrence. Nonparoxysmal AF is an independent predictor of late recurrence of AF in patients with very early recurrence.
authors: Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Shih-Lin
authors: SL
authors: Chang
authors: Hsuan-Ming
authors: HM
authors: Tsao
authors: Yenn-Jiang
authors: YJ
authors: Lin
authors: Li-Wei
authors: LW
authors: Lo
authors: Yu-Feng
authors: YF
authors: Hu
authors: Ta-Chuan
authors: TC
authors: Tuan
authors: Kazuyoshi
authors: K
authors: Suenari
authors: Ching-Tai
authors: CT
authors: Tai
authors: Cheng-Hung
authors: CH
authors: Li
authors: Tze-Fan
authors: TF
authors: Chao
authors: Yung-Kuo
authors: YK
authors: Lin
authors: Chin-Feng
authors: CF
authors: Tsai
authors: Tsu-Juey
authors: TJ
authors: Wu
authors: Shih-Ann
authors: SA
authors: Chen