Recurrent AF was defined as any episode of AF lasting >30 s on ECG or 24 hour Holter monitoring performed at 3, 6 and 12 months post procedure. Follow-up procedures were performed using radiofrequency ablation targeting reconnected PVs only. METHODS AND RESULTS: We included 557 consecutive patients undergoing a first PVI procedure with a second-generation 28 mm cryoballoon. We aimed to identify characteristics of patients who fail after two PVI procedures. Even after two PVIs some may suffer from AF recurrences. However, many patients need more than one procedure to maintain long-term sinus rhythm. INTRODUCTION: Pulmonary vein isolation (PVI) is an important treatment for atrial fibrillation (AF).
