Arrhythmias & electrophysiologyResearch article
Very late recurrence after atrial fibrillation ablation: Clinical characteristics and pulmonary vein reconnection patterns
- Consecutive patients undergoing redo atrial fibrillation (AF) ablation at Alfred Health and Cabrini Health (2007-2025)
- 2 centres
Authors' conclusion
The likelihood of PV reconnection declines significantly with increasing time to redo AF ablation; the majority of patients >5 years have enduring PV isolation. This suggests a greater contribution from non-PV triggers and/or AF substrate in this cohort.
Study context
- Population
- Patients undergoing redo AF ablation, grouped by redo intervalpatients undergoing redo AF ablation, 71 (12%) underwent very late redo (VLR) AF ablation · <1 year 236 · 1-5 years 289 · >5 years 71
- Participants
- 596 patients
- Comparison
- compare pulmonary vein findings across redo interval groups
- <1 yearn = 236
- 1-5 yearsn = 289
- >5 yearsn = 71
Main finding
As reported in the abstract
PV reconnection (any)
Further findings
| Outcome | rate ratio (95% CI) | P value | |
|---|---|---|---|
| Number of reconnected PVs per additional year from index to redo ablation · 8.6% lower expected number of reconnected PVs | 0.91 (0.88–0.95) | P < 0.001 | |
| 0.512Rate ratio (log scale) |
| Outcome | <1 year | 1-5 years | >5 years | Estimate | P value |
|---|---|---|---|---|---|
| Recurrent AF after VLR AF ablation · median follow-up of 243 days (IQR, 103-1097) from the repeat procedure | Not reported in the abstract | Not reported in the abstract | 45% |
Characteristics of VLR patients
- median redo interval, years (IQR, 5.9-8.2)
- 7.1
- mean age, years
- 62.1
- male
- 72%
- median CHA2DS2-VASc score (IQR, 1-3)
- 2
- paroxysmal AF at the redo procedure
- 57.7%
Original publication
Very late recurrence after atrial fibrillation ablation: Clinical characteristics and pulmonary vein reconnection patterns. Heart Rhythm. Published 29 August 2026. doi:10.1016/j.hrthm.2026.08.045
Summarised from the published abstract; every number is checked against it