ArticleHeart rhythm O22026
Early arrhythmia recurrence during the blanking period after pulsed-field ablation for atrial fibrillation.
Article in Heart rhythm O2, 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
Background: Pulmonary vein isolation is a cornerstone in the treatment of atrial fibrillation, with procedural success traditionally assessed after a 3-month "blanking period" to account for early postablation arrhythmias. However, emerging evidence challenges this paradigm, particularly with nonthermal energy modalities such as pulsed-field ablation (PFA), which induce minimal inflammatory response. Objective: The purpose of this study was to assess the prognostic relevance of early recurrence (ER) of atrial arrhythmia during the blanking period after PFA-based pulmonary vein isolation, with a focus on the timing of ER and its association with late recurrence (LR). Methods: In this single-center study, 241 patients with atrial fibrillation underwent first-time PFA and were followed for ≥12 months. Results: ER occurred in 48 (20%) of patients, with 23 (48%) occurring within the first month and 25 (52%) during the second or third month of ablation. LR was significantly more frequent in patients with ER ( Conclusion: The timing of ER after PFA strongly predicts LR, supporting reconsideration of the 90-day blanking period. It may be appropriate to shorten the blanking period for PFA, but late ER warrants clinical attention. Larger studies should validate timing-based blanking strategies.
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