Does less atrial fibrillation during the blanking period lead to better long-term outcomes? The effect of rapid cardioversion.

摘要

Early recurrence of atrial tachyarrhythmias (ERAT) within 1-3 months following catheter ablation of atrial fibrillation (AF) is commonly observed, with its prevalence varying from 35% to 65% in published studies.1"6 Patients who had ERAT were significantly less likely to have long-term freedom from recurrent AF than patients without ERAT. Sixty-eight to 97% of patients without ERAT were free from long-term AF.1"8 Many investigators believe that ERAT during the blanking period is an independent predictor of long-term AF recurrence. Nevertheless, approximately 30% to 57% of the patients with ERAF were also free from AF in the absence of antiarrhythmic drugs (AADs) during 6-41 months of follow-up.1"6 Accordingly, ERAT may manifest as a transient phenomenon in a substantial number of patients and does not necessarily indicate failure of the procedure. However, the significantly high rate of late recurrences of AF following ERAT highlights the importance of patient monitoring and optimal therapy for or prevention of ERAT during the blanking period.