Hunuk B, et al. - Patients with structurally normal hearts undergoing radiofrequency (RF) pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (AF) ablation were evaluated for the prevalence of early repolarization patterns (ERP). Further, its association with AF recurrence was determined. Researchers analyzed 434 patients (305 males, 58 ± 11 years), identifying ERP in 67 of them (15.4%) (Infero-lateral n = 26, inferior n = 23, lateral n = 18) who were also significantly younger, demonstrated longer PR-interval, and lower heart rates. During a mean follow-up of 22.1 ± 9.7 months, they observed AF recurrences in 107 patients. In middle-aged patients (≥40–<60 years; n = 206, 79% male), among those with an infero-lateral ERP vs those without, higher recurrence was noted (56.3% vs 19%). Infero-lateral ERP significantly predicted recurrence. Compared to the general population, the studied AF population showed a higher prevalence of ERP. This study suggests the predictive potential of infero-lateral ERP in baseline ECG for AF recurrence in the follow-up after RF-PVI in middle-aged patients.