%0 Journal Article
%T Redefining the blanking period after pulsed-field ablation in patients with atrial fibrillation.
%A Mohanty S
%A Torlapati PG
%A Casella M
%A Della Rocca DG
%A Schiavone M
%A Doty B
%A La Fazia VM
%A Pahi S
%A Pierucci N
%A Valeri Y
%A Gianni C
%A Al-Ahmad A
%A Burkhardt JD
%A Gallinghouse JG
%A Di Biase L
%A Chierchia GB
%A Nair DG
%A Dello Russo A
%A Tondo C
%A Natale A
%J Heart Rhythm
%V 0
%N 0
%D 2024 Aug 6
%M 39117003
%F 6.779
%R 10.1016/j.hrthm.2024.08.011
%X <B>BACKGROUND: </B>Recurrence during the 3-month blanking period after radiofrequency ablation of atrial fibrillation (AF) is typically not considered as a predictor for late recurrence.<BR><B>OBJECTIVE: </B>We investigated the significance of early recurrence as a risk factor for late recurrence in patients with AF receiving pulsed-field ablation (PFA).<BR><B>METHODS: </B>Consecutive patients undergoing PFA were prospectively followed up for 1 year. All patients received isolation of pulmonary veins. Additional ablation procedures were performed per operator's discretion. After the procedure, all remained on their previously ineffective antiarrhythmic drugs (AADs) during the 2-month blanking period after which the AADs were discontinued. Early recurrence was defined as atrial arrhythmia of >30-second duration during the 3-month blanking period, and any recurrence beyond 3 months was considered as late recurrence.<BR><B>RESULTS: </B>A total of 337 patients undergoing PFA for AF were included. Early recurrence was recorded in 53 patients (15.7%): 10 in the first month, 12 in the second month, and 31 in the third month. Of the 10 patients having recurrence during the first month, 7 (70%) remained in sinus rhythm after cardioversion whereas 3 (30%) underwent a redo procedure because of late recurrence. At 1 year, all patients with recurrence in the second and third months experienced late recurrence; among these patients, 10 (83.3%) of 12 and 27 (87%) of 31 underwent a redo procedure and the remaining 6 patients were in sinus rhythm on AADs.<BR><B>CONCLUSIONS: </B>In this consecutive series of patients with AF, early recurrence in the second or third month after the PFA procedure was associated with a high risk of late recurrence. Thus, blanking period could be redefined as 1 month after PFA.