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The more I think about this, the more inclined I am to conclude that the one-year-free-of-AF criterion is a decent one. It's a good long time for the heart to recover from the ablation experience, to be in healthy NSR, perhaps for the left atrium to return to a state of reduced enlargement (it does happen quite often), and for the heart to stabilize itself with a lower heart rate, which also has to happen for many ablatees, and it can take many months.
After one full year, many ablatees have recurrent AF. Is this because the technique is not very good, or its application, or is it that the heart continues to advance its 'agenda'? I suspect it is the heart's inclination, already being disordered (which ablation doesn't fix, only blocks) to continue to deteriorate with new foci, mitral valve prolapse, or non-reversed enlargement, or AV node block that changes the morphology of the heart, etc.
Those are my thoughts on the matter.
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@gloaming would recommend John Day’s book Afib Cure. EP that thinks most people can permanently cure afib. Gloaming your great, do you just spend all day helping people with practical help. Much needed, and so much appreciated. I have learned a lot from you.
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@gloaming I am just about 7 months post PFA with no recurrence of AFib. In my last tele-tag up with the EP team at UC Health in Aurora, CO I was told that there is a "probability" that I will need another PFA sometime in the next year+. Probability based on data not on me personally.