Limitations
Our study is a retrospective analysis of a consecutive cohort of
patients undergoing first time ablation for NPAF, thus reported results
may be confounded by other changes in practice over time. Patient
cohorts were consecutive, so differences in technique were also
separated by differences in times when procedures were performed.
Procedures for both cohorts of patients were completed over a 25-month
period, and no other significant change in practice besides transition
to the more limited lesion set occurred during this time. Ablation
lesions were generated in a power-controlled mode applying 20 to 35 W
for 20 to 40 seconds per lesion, thus results may not be applicable to
higher power, shorter duration approaches. The recurrence of atrial
arrhythmias could be underestimated in patients with asymptomatic
episodes not captured on 2-week monitors or during their scheduled
follow-up, although intensity of monitoring in the present cohort
compares favorably to intensity of monitoring in recent clinical trials.2,4–6,18–21 In patients that underwent repeat
ablation, ablation approach was at the discretion of the operator.