Introduction:
Pulmonary vein antral isolation (PVAI) is an effective strategy for catheter ablation of paroxysmal AF (PAF). 1–5 Various adjunctive ablation strategies have been evaluated for catheter ablation of non-paroxysmal AF (NPAF) and found to have limited success.2,4,6 Unfavorable outcomes for stepwise linear ablation of NPAF in clinical trials may be attributable to pro-arrhythmic effects of incomplete ablation lines, particularly in the absence of contact-force sensing (CFS) RFA catheters.4,7,8 It is unknown, however, if a more extensive initial ablation strategy results in improved outcomes following repeat ablation procedures. We compared multiple-procedure catheter ablation outcomes of stepwise linear ablation to left atrial (LA) posterior wall isolation (PWI) in patients undergoing NPAF ablation using a CFS RFA catheter.