Of course, rare patients with severe symptoms from recurrent atypical flutter refractory to antiarrhythmic drugs and cardioversion may require repeat ablation earlier than 3 months. In a study by Haissaguerre and colleagues, 2 early redo ablation led to an increase in procedures with no reduction in freedom from AF at approximately 1 year. 1 While early AF recurrence is one of the strongest predictors of late recurrence, the additional risks of a second ablation within 3 months of the first, including groin complications, additional radiation, the possibility that late pulmonary vein reconnection has not yet occurred and the additional cost argue that watchful waiting in the months after ablation is the most prudent strategy. Multiple studies have demonstrated that 30-50% of early recurrences of atrial fibrillation and atypical flutter do resolve on their own, particularly after ablation in patients with persistent AF.
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