Comparison between early versus late pulmonary vein isolation in the management of atrial fibrillation

Abstract

Background: Atrial fibrillation (AF) is the most common type of arrhyth-mia. The health burden of AF keeps increasing with the rising incidence of AF caused by the aging population and the high prevalence of unhealthy lifestyle. Pulmonary vein isolation (PVI) is the cornerstone of in-vasive rhythm control treatment in AF. Randomized controlled trials have shown superiority of an PVI strategy compared to conservative treatment. However, the best timing to perform a PVI to achieve the most optimal outcome is still unknown. Purpose: To investigate whether the timing of performing PVI has consequences for the AF management in terms of medical cost, the number of repeated electrical cardioversion and hospitalisations and mortality. Methods: In this monocentric retrospective observational study, all patients who underwent an electrical cardioversion and PVI between Jan-uary 2012 and January 2020 were included using a hospital administrative data record. Follow-up data were collected up to a maximum of 67 months. Early PVI is defined as patients receiving a PVI after a first electrical car-dioversion; late PVI is defined as patients receiving PVI after more than