Progression of Atrial Fibrillation after a Failed Initial Ablation Procedure in Patients with Paroxysmal Atrial Fibrillation: A Randomized Comparison of Drug Therapy vs. Re-Ablation

AHA – June 7, 2013

Background—The aim of this prospective randomized study was to assess if an early re-ablation was superior to AAD therapy in patients with previous failed PVI.

Methods and Results—Patients with paroxysmal AF eligible for AAD therapy or re-ablation after a previous failed initial PVI procedure were eligible for this study and were followed for 3 years to assess rhythm by means of an implanted cardiac monitor. After the blanking period post-ablation, 154 patients had symptomatic AF recurrences and were randomized to AAD (N = 77) or to re-PVI (N = 77). At the end follow-up, 61 (79%) patients in AAD group and 19 (25%) patients in re-ablation group demonstrated AF% progression (p<0.01). The AF% at 36 months was significantly greater in the AAD group compared with patients in the re-ablation group, 18.8 ± 11.4% vs 5.6 ± 9.5%, respectively (p<0.01). Read More