Clinical implications
ERATs are strong predictor of late recurrences.2,3There have been several reports that the incidence of late recurrences is significantly higher in patients with ERATs than in those without,5,6,20,21 which may be due to the recovery of the LA-PV connections or presence of incomplete ablation lesions. Our study demonstrated that AI-guided PVI could reduce ERATs and chronic PV reconnections after PVI more than could CF-guided PVI. We suggested that during PVI with radiofrequency CA, we should monitor AI during the ablation to create appropriate ablation lesions, which would lead to a durable PVI and decrease in ERATs.
On the other hand, ERAT can lead to an exacerbation of the patients’ quality of life. It is our belief that we should perform AI-guided PVI for AF in patients with severe symptoms, especially in those with tachycardia induced cardiomyopathy associated with heart failure or bradycardia-tachycardia syndrome with syncope.