Clinical Characteristics
After exclusion, 57 (15.1%) subjects from 370 patients undergoing successful PV isolation (218 paroxysmal and 152 persistent AF) showed acute PVR during waiting period. Each patient showed a single reconnection site. AEPVR was responsible for 32 (56.1%) of the patients, which were observed after a mean time of 40.3±11.9 minutes (left PVs: 45.7±9.2min, right PVs: 39.7±12.0min) counted from isolation of the ipsilateral PVs. Endocardial gap-related PVR was found in the rest 25 (43.9%) patients with a shorter observation time of 29.3±9.4 minutes compared to AEPVR group (P <0.001)(Figure 2). The characteristics of patients in AEPVR, Gap and Control group were demonstrated in Table 1. Additionally, a group of 14 patients showing delayed epicardial reconnection only during repeat ablation was reviewed.
Compared to patients without acute PVR, AEPVR group had a shorter diagnosis-to-ablation time (DAT)(3[2,14.5]months vs. 7[2,31]months, P =0.030), a lower left atrium diameter (37.7±6.9mm vs. 41.6±4.2mm,P <0.001) and volume (109.9±27.0ml vs. 132.4±33.4ml, P <0.001). Differences in age, sex, type of AF, hypertension, diabetes mellitus and other anatomic variations were not shown between AEPVR and the other 2 groups (P >0.05), respectively. AEPVR group had a shorter left atrium diameter (37.7±6.9mm vs. 42.6±6.9mm, P=0.011), a smaller left atrium volume (109.9±27.0ml vs. 133.6±28.9ml, P=0.002), and a slightly lower prevalence of hypertension (34.4% vs. 60.0%, P=0.054) compared to Gap group.