Effect of Cigarette Smoking on the Risk of Atrial Fibrillation Recurrence after Pulmonary Vein Isolation

Introduction: Previous studies have shown that atrial fibrillation (AF) recurrence after pulmonary vein (PV) isolation depends on various factors; however, the effect of cigarette smoking on AF recurrence after PV isolation has not been investigated.Methods and Results: Fifty-nine consecutive patients with drug-refractory AF (48 men and 11 women, mean age: 60 ± 11 years) who underwent PV isolation were included. The patients were divided into two groups: the non-smoker group, i.e., “never smokers (n = 29),” and the smoker group consisting of 30 patients who were either “former smokers (n = 15)” or “current smokers (n = 15)”. The diameter of all four PVs and the left atrial volume tended to be larger in the smoker group. During the mean follow-up period of 306 ± 95 days, the AF recurrence rate was higher in the smoker group than in the non-smoker group (43% vs. 14%, p < 0.05). The relative risk of AF recurrence associated with smoking was 3.19 (95% CI 1.23 to 8.27, p = 0.017). The AF recurrence rate was increased in both current smokers (40%) and former smokers (47%) compared to never smokers (14%).Conclusions: AF recurrence after PV isolation was significantly higher in the smoking patients. The substrate of AF may be worsened by exposure to cigarette smoking.