• Michael Efremidis, Konstantinos Letsas, Georgios Giannopoulos, Louisa Lioni, Konstantinos Vlachos, Dimitrios Asvestas, Dimitrios Karlis, Vasileios Kareliotis, Hrysoula Geladari, Antonios Sideris, and Spyridon Deftereos.
• Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, 'Evangelismos' General Hospital of Athens, Athens, Greece.
• Europace. 2015 May 1; 17 (5): 741-6.

AimThe objective of the study was to investigate whether early pulmonary vein reconnection (PVR) is a predictor of late arrhythmia recurrence after a single ablation procedure for paroxysmal atrial fibrillation (AF). Further ablation was delivered to patients with acute PVR to test whether this strategy could reduce recurrences.Methods And ResultsOne hundred and forty-four consecutive patients with symptomatic, drug-refractory paroxysmal AF, undergoing pulmonary vein isolation (PVI), were assigned to the 'PVR30 test' group, where PVR was monitored for 30 min after initial PVI and further ablation was applied if needed, and compared with a control group of 128 patients, where the procedure was terminated after initial successful isolation. During a mean follow-up of 17.7 months, sinus rhythm was maintained in 101 patients in the 'PVR30 test' group (70.1%) vs. 78 in the control group (60.9%) (P = 0.13). Among patients with acute PVR and reablation after 30 min, the recurrence rate was 45.3 vs. 39.1% in the control group (P = 0.47). Multivariable logistic regression analysis showed that PVR was independently associated with AF recurrence (adjusted hazard ratio 4.7, 95% confidence interval 1.8-12.2), along with left atrial diameter (adjusted hazard ratio 1.3/mm of higher diameter, 95% confidence interval 1.2-1.4).ConclusionIn patients with paroxysmal AF undergoing a single ablation procedure, PVR 30 min after the initial PVI is associated with late AF recurrence. However, the strategy of 30 min waiting and reablating does not appear to be superior to immediate termination of the procedure after initial PVI.Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

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