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Redefining the Blanking Period After Surgical Ablation For Atrial Fibrillation
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  • Jin Hee Choi,
  • Ki Won Hwang,
  • Soon Myung Jung,
  • Soo Yong Lee,
  • Sang Hyun Lee,
  • Min-Gu Chon,
  • Jeong-Su Kim,
  • Hyung Gon Je,
  • Yong-Hyun Park,
  • June Hong Kim,
  • Sang Kwon Lee,
  • Kook Jin Chun
Jin Hee Choi
Pusan National University Yangsan Hospital
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Ki Won Hwang
Pusan National University Yangsan Hospital
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Soon Myung Jung
Pusan National University Yangsan Hospital
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Soo Yong Lee
Pusan National University Yangsan Hospital
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Sang Hyun Lee
Pusan National University Yangsan Hospital
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Min-Gu Chon
Pusan National University Yangsan Hospital
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Jeong-Su Kim
Pusan National University Yangsan Hospital
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Hyung Gon Je
Pusan National University Yangsan Hospital
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Yong-Hyun Park
Pusan National University Yangsan Hospital
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June Hong Kim
Pusan National University Yangsan Hospital
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Sang Kwon Lee
Pusan National University Yangsan Hospital
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Kook Jin Chun
Pusan National University Yangsan Hospital
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Peer review status:UNDER REVIEW

07 May 2020Submitted to Journal of Cardiovascular Electrophysiology
07 May 2020Submission Checks Completed
07 May 2020Assigned to Editor
08 May 2020Reviewer(s) Assigned
22 May 2020Review(s) Completed, Editorial Evaluation Pending
22 May 2020Editorial Decision: Revise Minor
13 Jun 20201st Revision Received
15 Jun 2020Submission Checks Completed
15 Jun 2020Assigned to Editor
15 Jun 2020Reviewer(s) Assigned
28 Jun 2020Review(s) Completed, Editorial Evaluation Pending
30 Jun 2020Editorial Decision: Revise Minor
12 Jul 20202nd Revision Received
13 Jul 2020Submission Checks Completed
13 Jul 2020Assigned to Editor
13 Jul 2020Reviewer(s) Assigned

Abstract

Background Atrial tachyarrhythmias (ATAs) are common within the three-month blanking period following catheter ablation of atrial fibrillation (AF). However, little evidence is available regarding the current guidelines on the blanking period after surgical AF ablation. We investigate the incidence and significance of early recurrence of atrial tachyarrhythmia (ERAT) and evaluate the optimal blanking period after surgical AF ablation. Methods Data from 259 patients who underwent surgical AF ablation from 2009 to 2016 were collected. ERAT was defined as documented ATA episodes lasting for 30 seconds. A multivariate Cox proportional hazard model was constructed to evaluate the role of ERAT as a predictor of late recurrences (LR) for AF. Results In total, 127 patients (49.0%) experienced their last episodes of ERAT during the first (n=65), second (n=14), or third (n=48) month of the three-month blanking period (p<0.001). One-year freedom from ATAs was 97.8% in patients without ERAT compared with 95.4%, 64.3%, and 8.3% in patients with ERAT in the first, second, and third month after the index procedure, respectively (p<0.001). Hazard ratios of LR according to the timing of the last episode of ERAT first, second, and third month after the procedure were 2.84, 16.70, and 119.75, respectively. Conclusions The ERAT occurred in 49.0% of patients within the first three months after surgical ablation. The occurrence of ERAT within three months after surgical AF ablation was a significant independent predictor of LR. Hence, the currently accepted three-month blanking period needs to be redefined in patients with AF surgical ablation.