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An average, medium-term, complete success rate (no afib, no antiarrhythmics) of 80% is generally considered very high indeed even for relatively uncomplicated initial catheter ablations for the purpose of curing AF in paroxysmal afibbers. Now Japanese electrophysiologists report that success rates as high as 92% can be achieved simply by re-ablating conduction gaps making their appearance during a 90-minute wait period following the “official” completion of the pulmonary vein isolation procedure. Electrophysiologic measurements made at the start of repeat procedures have clearly shown that the need for a second procedure is almost entirely due to the appearance of electrically conductive gaps in the original lesion rings. The Japanese study would indicate that most of these reconnections occur within a 90-minute period following the end of the procedure. Thus, it would make imminent sense to add 90 minutes to initial ablations for the purpose of doing the isoproterenol/ATP challenges as outlined by the Japanese researchers. Also in this issue we report that even multiple catheter ablations do not appear to impair left atrial function, that post-ablation therapy with corticosteroids decrease the risk of early AF recurrence, that an apple a day keeps stroke away, and that vitamin C is highly effective in preventing heart failure. Wishing you good health and lots of NSR, Hans
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