INTRODUCTION
Electrical isolation of the pulmonary veins (PVI) is a radical treatment
for paroxysmal atrial fibrillation (PAF). Despite the acute success of
PVI, recurrence of atrial tachyarrhythmia is common. Recurrence of
atrial tachyarrhythmias within the first 3 months after an atrial
fibrillation (AF) ablation procedure is defined as early recurrence
(ER). ER is distinguished from late recurrence (LR) of atrial
tachyarrhythmia, because only half of patients with ER also have
LR.1 Accordingly,
guidelines and expert consensus statements do not recommend early
re-ablation during the first 3 months. However, some studies have shown
that ER occurring in a later period was more strongly associated with
long-term ablation failure in patients who underwent PVI using local
electrode attenuation and impedance drop-guided radiofrequency catheter
ablation (RFCA) and more than 90% of patients with ER during the
3rd month post-ablation develop
LR.2,
3
Recently, the conventional ablation procedure has been replaced by
contact force (CF) technology for PVI, and some studies have shown that
CF-guided PVI is more effective in reducing AF recurrence than the
conventional non-CF-guided
PVI.4 However, the
significance of ER episodes after CF-guided ablation in terms of LR
remains unclear. Therefore, the objective of this study was to compare
the significance of ER as a risk factor for LR in patients with
paroxysmal AF (PAF) treated by CF and non-CF-guided ablation procedures.