Patients with paroxysmal atrial fibrillation (PAF) can be treated by pulmonary vein (PV) isolation. However, the recurrence rate after this procedure is relatively high. We sought to evaluate the quality of life (QOL) of patients with PAF recurrence after PV isolation and to analyze factors related to recurrences. Seventy-two drug-refractory PAF patients (59 men, 13 women, mean age 52 +/- 10) were included. PV isolation was based on the disappearance of PV potentials recorded from a Lasso catheter after segmental ostium ablation. Automatic foci were observed in 47 patients (65.3%) during the procedure. A mean of 3.1 +/- 0.9 PVs was isolated. Patients were followed for a mean of 10.3 +/- 5.1 months, during which 27 experienced >1 episode of PAF. QOL was scored from 0 (situation before ablation) to 10 (no episode after ablation) based on a questionnaire completed by 69 patients (95.8%). QOL was judged very good in 26 patients (none with PAF recurrences), better in 30 (15 with PAF recurrences), unchanged in 11 (10 with recurrences), and worse in 2 patients with PAF recurrences. Longer histories of PAF and a lower percentage of patients with automatic foci identified during the procedure were observed in the group with, than in the group without recurrences (P < 0.05). PV isolation improved QOL in patients with PAF, including in patients with recurrences. The length of PAF history and observation of automatic foci may be of importance for recurrences of PAF during long-term follow-up.