Early postablation atrial fibrillation recurrence: Time to blank the blanking period?

Early recurrence of atrial arrhythmia (ERA) is commonly seen following catheter ablation of atrial fibrillation (AF), with reported incidences of up to 61% in the first three months. 1 Steinberg C. Champagne J. Deyell M.W. Dubuc M. Leong-Sit P. Calkins H. et al. Prevalence and outcome of early recurrence of atrial tachyarrhythmias in the cryoballoon vs irrigated radiofrequency catheter ablation (CIRCA-DOSE) study. Heart Rhythm. 2021; 18: 1463-1470 Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar ERA is often attributed to transient inflammation induced by tissue damage during ablation and short-term imbalances in autonomic innervation. This forms the physiologic rationale for the accepted convention of a 3-month blanking period, during which arrhythmia recurrences are presumed to be relatively benign and not indicative of treatment failure. With increasing data indicating that early AF recurrence is a predictor of late recurrence, the 3-month blanking period has been called into question. 2 Wen S. Liao Y. Khurana T.S. Bai R. Reconsideration of the definition of blanking period and significance of early recurrences after catheter ablation of atrial fibrillation. Curr Opin Cardiol. 2024; 39: 15-19 Crossref PubMed Scopus (0) Google Scholar Early atrial fibrillation recurrence post catheter ablation: Analysis from insertable cardiac monitor in the era of optimized radiofrequency ablationHeart RhythmPreviewEarly recurrence of atrial tachyarrhythmia (ERAT) is associated with ablation-induced pro-arrhythmogenic inflammation; however, existing studies used intermittent monitoring or non-optimized RF applications (non-contiguous or without ablation index target value). Full-Text PDF