Mechanisms and clinical significance of early recurrences of atrial arrhythmias after catheter ablation for atrial fibrillation

Abstract

Early recurrence of atrial arrhythmias (ERAA) after ablation is common and strongly predicts late recurrences and ablation failure. However, since arrhythmia may eventually resolve in up to half of patients with ERAA, guidelines do not recommend immediate reintervention for ERAA episodes occurring during a 3-mo post-ablation blanking period. Certain clinical demographic, electrophysiologic, procedural, and ERAA-related characteristics may predict a higher likelihood of long-term ablation failure. In this review, we aim to discuss potential mechanisms of ERAA, and to summarize the clinical significance, prognostic implications, and treatment options for ERAA.

Keywords: Atrial fibrillation; Recurrence; Catheter ablation; Pulmonary vein isolation

Core tip: There have been several studies examining the predictors of early recurrences of atrial arrhythmias (ERAA) during the blanking period after atrial fibrillation (AF) ablation and the predictive value of such early recurrences on late recurrences. In this review, we summarize the mechanisms and predictors, clinical significance, prognostic implications, and treatment options of ERAA after AF ablation.