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.