{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:09:16Z","timestamp":1792642156412,"version":"4.5.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T00:00:00Z","timestamp":1743984000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Factors contributing to early recurrence after atrial fibrillation (AF) ablation, particularly with pulsed\u2010field ablation (PFA), are poorly understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aimed to evaluate the significance of early recurrence and identify factors associated with its occurrence, focusing on predicting late recurrence in AF patients treated with PFA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 620 consecutive patients referred for their first paroxysmal or early persistent AF ablation underwent the procedure using the FARAPULSE PFA system (Boston Scientific) across 10 centers. Early recurrence was defined as atrial arrhythmia of &gt;\u200930\u2010s duration during the 3\u2010month blanking period, and any recurrence beyond 3 months was considered as late recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 44 (7.1%) patients experienced early recurrences (median time to recurrence: 56 [22\u201375] days). At multivariate logistic analysis adjusted for baseline confounders larger left atrial volume index (LAVi) (1.03, 1.01\u20131.06, <jats:italic>p<\/jats:italic>\u2009=\u20090.0034) was significantly associated with early recurrences. In total, 113 (18.2%) patients experienced late recurrences. Factors independently associated with late recurrences included age (1.03, 1.01\u20131.05, <jats:italic>p<\/jats:italic>\u2009=\u20090.0077), sleep apnea (3.17, 1.73\u20135.81, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), and early recurrences (3.26, 2.01\u20135.29, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Early recurrences were associated to late recurrences also in paroxysmal AF only patients (40.0% vs. 16.9%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this cohort of AF patients undergoing PFA, early recurrences significantly increased the risk of late recurrences, highlighting their potential as a predictive marker for long\u2010term outcomes. Moreover, larger LAVi was associated with early recurrences.<\/jats:p><jats:p><jats:bold>Trial Registration:<\/jats:bold> Advanced TecHnologies For SuccEssful AblatioN of AF in Clinical Practice (ATHENA). URL: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\/\">http:\/\/clinicaltrials.gov\/<\/jats:ext-link>. Identifier: NCT05617456.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16670","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T07:16:03Z","timestamp":1744010163000},"page":"1323-1332","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Insight Into Early Recurrences After Pulsed\u2010Field Ablation for Atrial Fibrillation: Results From a Multicenter Experience"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3938-4948","authenticated-orcid":false,"given":"Antonio","family":"Bisignani","sequence":"first","affiliation":[{"name":"Center of Excellence in Cardiovascular Sciences Ospedale Isola Tiberina \u2010 Gemelli Isola Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Solimene","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Public Health Marche Polytechnic University Ancona Italy"},{"name":"Montevergine Clinic Mercogliano Avellino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2131-1110","authenticated-orcid":false,"given":"Saverio","family":"Iacopino","sequence":"additional","affiliation":[{"name":"Maria Cecilia Hospital GVM Care &amp; Research Cotignola Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Polselli","sequence":"additional","affiliation":[{"name":"Center of Excellence in Cardiovascular Sciences Ospedale Isola Tiberina \u2010 Gemelli Isola Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Dello Russo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Public Health Marche Polytechnic University Ancona Italy"},{"name":"Cardiology and Arrhythmology Clinic Marche University Hospital Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Tondo","sequence":"additional","affiliation":[{"name":"Department of Clinical Electrophysiology &amp; Cardiac Pacing Centro Cardiologico Monzino, IRCCS Milan Italy"},{"name":"Department of Biomedical, Surgical and Dental Sciences University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Rossillo","sequence":"additional","affiliation":[{"name":"San Bortolo Hospital Vicenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakis","family":"Themistoclakis","sequence":"additional","affiliation":[{"name":"Dell'Angelo Hospital Mestre Venice Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruggero","family":"Maggio","sequence":"additional","affiliation":[{"name":"Degli Infermi Hospital Rivoli Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Russo","sequence":"additional","affiliation":[{"name":"San Filippo Neri Hospital Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Volpicelli","sequence":"additional","affiliation":[{"name":"Cardiovascular Diseases and Electrophysiology Unit, S. Maria della Piet\u00e0 Hospital Nola Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Schillaci","sequence":"additional","affiliation":[{"name":"Montevergine Clinic Mercogliano Avellino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0720-3380","authenticated-orcid":false,"given":"Marco","family":"Schiavone","sequence":"additional","affiliation":[{"name":"Department of Clinical Electrophysiology &amp; Cardiac Pacing Centro Cardiologico Monzino, IRCCS Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Colella","sequence":"additional","affiliation":[{"name":"Maria Cecilia Hospital GVM Care &amp; Research Cotignola Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Casella","sequence":"additional","affiliation":[{"name":"Maria Cecilia Hospital GVM Care &amp; Research Cotignola Italy"},{"name":"Cardiology and Arrhythmology Clinic Marche University Hospital Ancona Italy"},{"name":"Department of Clinical, Special and Dental Sciences Marche Polytechnic University Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8823-0334","authenticated-orcid":false,"given":"Maurizio","family":"Malacrida","sequence":"additional","affiliation":[{"name":"Boston Scientific Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Zucchelli","sequence":"additional","affiliation":[{"name":"Second Division of Cardiology, Cardiac\u2010Thoracic\u2010Vascular Department New Santa Chiara Hospital, Azienda Ospedaliero Universitaria Pisana Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Center of Excellence in Cardiovascular Sciences Ospedale Isola Tiberina \u2010 Gemelli Isola Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae176"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux275"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euae043"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.121.010661"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2023.11.001"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.08.011"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.16083"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-023-01699-2"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.16246"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-024-01835-6"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2012.02416.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.12.034"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2021.01.011"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.11.020"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.16087"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euaf007"},{"issue":"24","key":"e_1_2_10_18_1","first-page":"02810","article-title":"Prevalence, Timing, and Impact of Early Recurrence of Atrial Tachyarrhythmias After Pulsed Field Ablation: A Secondary Analysis of the PULSED AF Trial","volume":"1547","author":"Boersma L. 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