PVCs detected within the first 6 months after catheter ablation for paroxysmal atrial fibrillation (PAF) were associated with an increased likelihood of atrial arrhythmia recurrence. Published in JACC: Clinical Electrophysiology, the analysis reveals that early postablation PVCs identify patients at higher risk of recurrence after ablation for PAF.

The analysis included 361 patients in the Food and Drug Administration–regulated multicenter admIRE trial, which evaluated pulsed field ablation using a variable-loop catheter. Transtelephonic monitoring was performed for up to 12 months to detect PVCs and atrial arrhythmias.
During the first 180 days after ablation, 135 patients (37.5%) experienced PVCs. Logistic regression showed that those with PVCs had more than twice the risk of atrial arrhythmia recurrence between 91 and 365 days postprocedure compared with those without PVCs (odds ratio [OR] 2.1; 95% confidence interval [CI] 1.2–3.5; P = 0.006).

A second validation cohort of 261 patients treated with very high-power, short-duration radiofrequency ablation confirmed the findings, with early PVCs again predicting recurrence (OR 2.3; 95% CI 1.2–4.6; P = 0.015). Early PVCs following PAF ablation identify patients at increased risk of recurrence. Whether PVCs directly trigger or reflect shared underlying mechanisms remains uncertain.