ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2026
Shortest pulmonary vein atrial fibrillation cycle length identifies pulmonary vein isolation responders beyond clinical atrial fibrillation pattern: the FARS-AF II study.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsAtrial fibrillation cycle length (AF-CL) measured in the pulmonary veins (PVs) with a novel simple method [the average of the 10 consecutive Fastest Atrial Repetitive Similar signal interval (FARS10)] accurately identified pulmonary vein isolation (PVI) responders in a preliminary study. This study aims to evaluate differences in PV-FARS10 between paroxysmal and persistent AF and to define the optimal cut-off to predict PVI-only approach success in a large population. METHODS AND
resultsWe prospectively enrolled consecutive patients with persistent or paroxysmal AF undergoing first PVI in a single-centre study. The primary endpoint was atrial arrhythmia recurrence. A total of 219 patients (61.8 ± 11.2 years, 25.1% female) were included, with 70 patients (32%) having paroxysmal AF and 149 patients (68%) persistent AF. After a median follow-up of 18.0 [interquartile range (IQR) 10.2-42.3] months, 72 (32.9%) patients experienced AF/atrial flutter (AFL)/atrial tachycardia (AT) recurrence. Patients with shortest PV-FARS10 ≤ 155 ms had a lower rate of AF/AFL/AT recurrence compared to those with shortest PV-FARS10 > 155 ms in the overall population (HR 0.34, P < 0.001), in persistent AF (HR 0.40, P = 0.002), and in paroxysmal AF (HR 0.18, P = 0.01). In multivariable analysis-which included age, sex, body mass index, CHA2DS2-VA score, obstructive sleep apnoea syndrome, duration of AF, AF type (paroxysmal vs. persistent), left ventricular ejection fraction, left atrial volume index, shortest PV-FARS10/left atrial appendage-FARS10, and AF termination during ablation-only the shortest PV-FARS10 ≤ 155 ms was the significant predictor of AF/AFL/AT recurrence-free survival in the overall population (HR 0.45, CI: 0.26-0.78, P = 0.005). Paroxysmal AF patients more frequently had shortest PV-FARS10 ≤ 155 ms than persistent AF patients (61.4% vs. 42.3%, P = 0.009).
conclusionPV-FARS10 can accurately identify PVI responders among patients with persistent and paroxysmal AF. Patients with slow PV (shortest PV-FARS10 > 155 ms) experience a higher rate of AF/AFL/AT recurrence after PVI-only approach. The shortest PV-FARS10 ≤ 155 ms occurs more frequently in paroxysmal AF patients than in persistent AF patients.
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