Evaluation of redo procedures in blanking period following atrial fibrillation catheter ablation

FUNDING ACKNOWLEDGEMENTS: Type of funding sources: None. BACKGROUND AND OBJECTIVE: Although early recurrence after atrial fibrillation catheter ablation (AFCA) is a risk factor for late recurrence, 3 months blanking period (BP) is generally an accepted period to wait for re-do intervention. In this study, we aimed to evaluate the cases of early recurrences in BP after AFCA using either radiofrequency (RF) or cryo-balloon (CB). METHOD: One thousand fifty patients who had undergone AFCA between January 2017 and January 2022 were evaluated retrospectively. Seventy-five patients had documented tachyarrhythmia episodes in the BP. Among these, 33 patients underwent electrophysiologic study (EPS) and re-do catheter ablation for atrial tachyarrhythmia. RESULTS: The index procedure was performed with CB in 15 (45.5%) patients and RF in 18 (54.5%). 20 (60.1%) patients had paroxysmal atrial fibrillation before the index procedure. EPS was done routinely in all patients after the recurrence. In 3 patients, typical AVNRT was induced in EPS, the slow pathway was ablated, and substrate mapping (SM) was not performed. In 19 patients, atrial tachycardia, whose 3 were typical atrial flutter, was induced. Pulmonary vein (PV) reconnection was detected in 7 patients whose three also had non-PV triggers. CONCLUSION: PV reconnection is responsible for the recurrence during the period of BP in a small percentage of patients. However, additional triggers are present in most. The optimal approach for the recurrence occurring in BP is still controversial. Performing EPS and SM may reduce the recurrence rate in this patient group. [Figure: see text] [Figure: see text]