Concomitant left atrial appendage closure (LAAC) and pulmonary vein isolation (PVI), in Pts sharing both indications, has been proven safe and effective. The left atrial appendage (LAA) serves as a reservoir and contributes to atrial compliance. We wanted to investigate whether LAAC was followed by an increase in the atrial fibrillation (AF) recurrence rate. We compared the long-term follow-up of pts with AF undergoing PVI alone versus pts undergoing PVI+LAAC. This study included all pts undergoing PVI + LAAC between 2015 and 2019. These pts were compared with propensity-matched individuals who underwent PVI isolation during the same period. The pts were matched for age, sex, AF type, antiarrhythmic therapy, CHADS-VASC, BMI, left atrial area, and ablation technique. The primary end-point was recurrence-free survival at 24 months. During the study period, 41 pts undergoing PVI+LAAC were compared with 41 matched individuals undergoing PVI alone. 51 out of 82 Pts (62%) were male, 57 (70%) had paroxysmal AF, 75 (91%) underwent cryo-ablation and the mean CHADS-VASC score was 2,5. After a mean follow-up of 12,6 months, recurrence-free survival was 82% in the PVI-only group and 64% in the PVI+LAAC group. Pts undergoing PVI+LAAC had more than double the risk of AF recurrence compared to the control group (HR 2,5; 95% C.I. 1-6,4; log-rank p=0,05). LAAC appeared to worsen the outcome of patients undergoing PVI isolation, increasing the recurrence rate. Negative remodeling due to the LAA exclusion from the atrial hemodynamics may explain these results. Further study should confirm our findings and investigate our hypothesis.