title: Does a blanking period after pulmonary vein isolation impact long-term results? Results after 55 months of follow-up.
abstract: BACKGROUND
  The aims of the study are 1) to assess antiarrhythmic prophylaxis efficacy during the first 2 months after radiofrequency ablation (ARF) due to AF; 2) to define risk factors for early AF recurrence (EAFR) after ARF; 3) to determine the long-term follow-up results and risk factors for late AF recurrence (LAFR).
  
  
  METHODS
  A total number of 210 consecutive patients who had undergone ARF due to AF were analyzed. Patients were randomized into three groups: Group 1 (G1), without any anti-arrhythmic drug (AAD); Group 2 (G2), with amiodarone or sotalol; Group 3 (G3), with last ineffective AAD. The study was designed to analyze two periods: short-term observation, the first 2 months after ARF; and at least 2 years of long-term follow-up.
  
  
  RESULTS
  After 2 months, clinical data were collected from 171 patients (123 males, mean age of 50.3 years; persistent AF in 19.8%; lone AF in 36.6%). Sinus rhythm (SR) was maintained in 84 (49.1%) patients; 35 (20.4%) patients presented with a single episode of AF, 39 (23%) patients experienced a reduction in number of AF episodes, and 13 (7.5%) patients showed no improvement. No predisposing factor for early recurrence was found. After a mean follow-up of 55 months, clinical data were collected in 137 patients, of which 47 (34%) maintained SR. Those more likely to sustain SR were: males (82.9% vs. 62.2%; p = 0.018), younger patients (44.8 ± 12.7 vs. 52.5 ± 9.9; p = 0.0001), patients with smaller left atrium diameter (4.05 ± ± 0.49 cm vs. 4.25 ± 0.51 cm; p = 0.04), and those without any AF recurrence during the first 2 months after ARF (78.7% vs. 35.6%; p < 0.0001). In the multivariable analysis, the independent risk factors for LAFR were hypertension (p < 0.001) and persistent AF (p = 0.014).
  
  
  CONCLUSIONS
  Antiarrhythmic prophylaxis does not affect the number of AF recurrences during the first 2 months after ablation. SR maintenance during a blanking period after AF ablation is a positive prognostic factor in long-term follow-up. Persistent AF and hypertension are independent risk factors for late AF recurrence after pulmonary vein isolation.
authors.affiliation: 1st Chair and Depar tment of Cardiology, Medical University of Warsaw, Warsaw, Poland. piotr.lodzinski@me.com.
authors.forename: Piotr
authors.initials: P
authors.lastname: Lodziński
authors.forename: Marek
authors.initials: M
authors.lastname: Kiliszek
authors.forename: Edward
authors.initials: E
authors.lastname: Koźluk
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Piątkowska
authors.forename: Paweł
authors.initials: P
authors.lastname: Balsam
authors.forename: Janusz
authors.initials: J
authors.lastname: Kochanowski
authors.forename: Piotr
authors.initials: P
authors.lastname: Scisło
authors.forename: Radosław
authors.initials: R
authors.lastname: Piątkowski
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
mesh_terms: D000328:Adult; D000638:Amiodarone / Q000008:administration & dosage* / Q000009:adverse effects; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011044:Poland; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012307:Risk Factors; D013015:Sotalol / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D013015:Sotalol; D000638:Amiodarone