Discussion
In this retrospective study of 1004 patients undergoing initial AF ablation, we found that DHF which needed medical therapy during post-ablation hospitalization or re-hospitalization < 90 days after the ablation occurred in 32 (3%) patients. DHF frequently occurred in the first 48 hours after the procedure. Independent predictors of DHF were lower Δheart rate and early recurrence of AF. In particular, lower Δheart rate was an independent predictor of early peri-procedural DHF, which occurred within 2 days after the procedure, and early recurrence of AF was an independent predictor of late peri-procedural DHF, which occurred ≥ 3 days after the procedure. Freedom from AF recurrence was similar between patients with and without DHF. In contrast, freedom from late phase DHF requiring re-hospitalization was significantly lower in patients with DHF than without DHF.