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Since the initial description of the pivotal role of the pulmonary veins (PVs) in the initiation of atrial fibrillation (AF), significant strides have been made in the ablative treatment of AF.1 Recently, 5-year follow-up data on the outcome following PV isolation for the treatment of AF were reported.2 3 In patients with paroxysmal AF, arrhythmia recurrence was common following initial PV isolation but decreased to about 20% after a median of one (one to three) procedure.2 In a second study, success rate was lower in patients with long-standing persistent AF.3 In a systematic review, non-paroxysmal AF was an independent risk predictor for arrhythmia recurrence following first-time PV isolation.4
Several other factors have demonstrated predictive value in patients undergoing AF ablation. Left atrial (LA) size commonly serves as a surrogate marker for atrial remodelling and is easily and reproducibly measured using preprocedural echocardiography. LA diameter predicts first-time occurrence of AF as well …