Introduction
Atrial fibrillation (AF) is a common preoperative arrhythmia in patients undergoing cardiac surgery. Concomitant surgical AF ablation with cardiac surgery is reasonable in selected patients with AF undergoing other cardiac surgical procedures due to valvular or coronary artery diseases.1 Surgical AF ablation has been recognized to reduce AF-related symptoms, improve hemodynamic parameters, and reduce thromboembolic risk by restoring and maintaining sinus rhythm (SR).2-4 Nevertheless, approximately 40% of all patients undergoing surgical AF ablation have postoperative AF.5,6 Catheter ablation is a highly successful procedure in eliminating atrial tachyarrhythmias (ATAs) and maintaining SR after surgical AF ablation. A blanking period of three months has been universally accepted after catheter AF ablation, and AF recurrence during the blanking period is not considered a treatment failure nor is it associated with long-term AF recurrence.7
However, little is known about early recurrence of atrial tachyarrhythmia (ERAT), which is defined as recurrence within the first three months after surgical AF ablation. There is currently a lack of studies evaluating the optimal blanking period after surgical ablation. Therefore, we aimed to investigate the incidence and significance of ERAT after surgical AF ablation as a predictor of late recurrence (LR) and to evaluate the optimal blanking period after surgical AF ablation using receiver operating curve (ROC) analysis.