Condensed Abstract
It is unknown if more extensive initial ablation results in improved outcomes following multiple ablation procedures. We analyzed consecutive patients with non-paroxysmal AF who underwent first-time ablation using stepwise (n=111) or left atrial posterior wall isolation (PWI, n=111) approach. Over 36 months follow-up, compared to a stepwise approach, a PWI approach resulted in similar recurrence of any atrial arrhythmia >30s, but less persistent arrhythmia recurrence, fewer repeat ablations, and fewer recurrences after repeat ablation.