Editorial to “Longer diagnosis‐to‐ablation time is associated with recurrence of atrial fibrillation after catheter ablation: Systematic review and meta‐analysis”

Rheumatic and ischemic heart disease, hypertension, and congestive heart failure are important risk factors for the development of AF leading to a prevalence of as high as 50% in patients with overt congestive heart failure. Besides the progressive changes due to underlying heart disease, atrial fibrillation itself causes progressive electrophysiological and/or structural changes to the atria, which promote the initiation or perpetuation of AF. Bunch et al demonstrated that delays in the treatment of AF with catheter ablation impact the procedural success rates and are associated with a worse prognosis, as measured by heart failure events and death. Several factors including a female sex, persistent/long‐lasting persistent AF, left atrial enlargement, presence of left atrial scarring, valvular heart disease, renal failure, lack of a successful anatomical ablation of all targeted pulmonary veins, acute pulmonary vein reconnections during the pulmonary vein isolation, and early recurrence of AF in the blanking period were reported to be associated with an increasing recurrence of AF after catheter ablation.