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XVein. E1260@CR31]].

The present cohort of patients was younger and less comorbid than our previous report [[@CR4]] which may be relevant in this context. To achieve similar levels of freedom from AF recurrence as observed by group 1 we had to use more ablation lines and the majority of VT was targeted. The lower rate of symptomatic recurrences is probably due to a more accurate long-term subcardiac defibrillation pacing using the non-invasive subcutaneous recording and pacing device, as a second line treatment (group 2).

For comparison, the most recently published single center prospective study [[@CR5]] was also included in Fig. 2{ref-type=”fig”}. Besides a higher recurrence rate of 20% after a mean follow-up of 19 ± 13 months, both patient groups were older, had a higher rate of ischemic heart disease and were on AADs at baseline. Dzik-Juraszek et al. [[@CR5]] showed that OACs given at study end did not influence the recurrence rate in the non-anticoagulated patients. Similarly, Tzounis et al. [[@CR32]] showed in a prospective study that recurrence rates after initial AF ablation did not differ among patients with or without OACs during follow-up. Our patient cohort is therefore likely to have been fairly representative for the recurrence rate in this patient population.

Conclusion

An initial 3-month PO AAD use during periprocedural anticoagulation might possibly prevent the occurrence of post-ablation VT recurrences in patients with AF and structural heart disease. However, according to our study results this benefit is limited to the treated cohort and no difference was seen in the overall recurrence rate. Nevertheless, an early anticoagulation strategy is still recommended. Additional studies are needed to further investigate the role of PO AADs in the reduction of recurrence.

AAD
Antiarrhythmic drug
AF
Atrial fibrillation

CR

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