Abstract
Background Atrial tachyarrhythmias (ATAs) are common within the
three-month blanking period following catheter ablation of atrial
fibrillation (AF). However, little evidence is available regarding the
current guidelines on the blanking period after surgical AF ablation. We
investigate the incidence and significance of early recurrence of atrial
tachyarrhythmia (ERAT) and evaluate the optimal blanking period after
surgical AF ablation. Methods Data from 259 patients who underwent
surgical AF ablation from 2009 to 2016 were collected. ERAT was defined
as documented ATA episodes lasting for 30 seconds. A multivariate Cox
proportional hazard model was constructed to evaluate the role of ERAT
as a predictor of late recurrences (LR) for AF. Results In total, 127
patients (49.0%) experienced their last episodes of ERAT during the
first (n=65), second (n=14), or third (n=48) month of the three-month
blanking period (p<0.001). One-year freedom from ATAs was
97.8% in patients without ERAT compared with 95.4%, 64.3%, and 8.3%
in patients with ERAT in the first, second, and third month after the
index procedure, respectively (p<0.001). Hazard ratios of LR
according to the timing of the last episode of ERAT first, second, and
third month after the procedure were 2.84, 16.70, and 119.75,
respectively. Conclusions The ERAT occurred in 49.0% of patients within
the first three months after surgical ablation. The occurrence of ERAT
within three months after surgical AF ablation was a significant
independent predictor of LR. Hence, the currently accepted three-month
blanking period needs to be redefined in patients with AF surgical
ablation.