This meta-analysis shows that durable PVI is associated with a lower risk of AF recurrence after catheter ablation. However, the association was modest, and PV electrical reconnection is common, affecting 58% of AF-free patients. Analysis of studies that included exclusively patients with paroxysmal AF showed a weaker relationship. Additional research is warranted to better understand the mechanism(s) of benefit of catheter ablation for AF and investigate whether PVI should be the primary goal.