After atrial fibrillation (Afib) (AF) ablation, what is the likelihood that the patient will undergo repeat ablations?

Updated: Nov 18, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Patients opting for AF ablation should be told to expect to undergo repeat ablations because these are not uncommon and they improve overall success. [136] In a randomized, clinical trial, a repeat pulmonary vein isolation procedure was more effective than the use of antiarrhythmic drugs in preventing recurrences of paroxysmal AF. [137, 138] The results of the trial further suggested that switching to antiarrhythmic drugs may give the AF time to worsen.

In this study, 154 patients with a 4- to 5-year history of symptomatic AF before the first ablation were randomized to antiarrhythmics or to repeat pulmonary vein isolation. [138] By 3 months, the AF burden was significantly lower in the repeat pulmonary vein isolation group than in the antiarrhythmics group (1.9% vs 3.3%). The AF burden then began to rise in the antiarrhythmics group, reaching 18.8% by 36 months. In contrast, the AF burden did not begin to rise in the reablation group until 15 months after the procedure, reaching just 5.6% at 36 months.

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