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.