title: Early recurrence of atrial fibrillation as a predictor for 1-year efficacy after successful phased RF pulmonary vein isolation: evaluation of complaints and multiple Holter recordings.
abstract: BACKGROUND
  Early arrhythmia recurrences after pulmonary vein isolation (PVI) for atrial fibrillation (AF) are accepted as part of the blanking period. Their relevance for long-term efficacy is not well-known. We evaluated patients, who came to hospital with a documented recurrence of AF, or had a registered episode of AF on the 24-hour Holter 6 weeks after PVI and compared it with long-term outcome.
  
  
  METHODS
  One hundred consecutive patients with paroxysmal AF were treated with the PVAC. In the 3-month blanking period patients who came to hospital with a documented recurrence of AF on ECG were recorded. 6 weeks after procedure a 24-hour Holter was performed. After 3 months patients were asked if they felt a relapse. Follow-up was performed at 3, 6, and 12 months with ECG, 7-day Holter at 6 and/or 12 months, and event recording if needed.
  
  
  RESULTS
  Within the blanking period, 25/100 (25%) patients had a documented recurrence of AF while 46/100 (46%) patients felt a relapse. After the blanking period up to 12 months, 53/100 (53%) patients were free of AF without anti-arrhythmic drugs. Multivariate regression analyses revealed that absence of AF in the blanking period (OR 0.22 95%CI [0.05-0.98]) and absence of a relapse of symptoms suspect for AF during the blanking period (OR 0.21 95%CI [0.06-0.52]) were independent predictors of successful long-term outcome.
  
  
  CONCLUSIONS
  Poor long-term outcome is strongly related to patients who experienced palpitations with ECG documented AF, AF on the 24-hour Holter at 6 weeks after PVI and a relapse in the blanking period.
authors.affiliation: Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands. a.mulder@antoniusziekenhuis.nl
authors.forename: Anton A W
authors.initials: AA
authors.lastname: Mulder
authors.forename: Maurits C E F
authors.initials: MC
authors.lastname: Wijffels
authors.forename: Eric F D
authors.initials: EF
authors.lastname: Wever
authors.forename: Lucas V A
authors.initials: LV
authors.lastname: Boersma
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods* / Q000639:trends; D015331:Cohort Studies; D015716:Electrocardiography, Ambulatory / Q000379:methods* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011237:Predictive Value of Tests; D011667:Pulmonary Veins / Q000502:physiology / Q000601:surgery*; D055502:Secondary Prevention; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome