4.6 Limitations
Despite the success in the outcomes of our study, it does not preclude limitations: First, it is well known that the esophagus is a movable organ, and its exact location might vary at the time of ablation. In this study, the CT images were obtained before the AF ablation procedure, which might not give the actual location of the esophagus intraoperatively. However, another study25 showed high concordance between the esophageal location on CT scan and the Carto map, especially in the middle and inferior portion of the LA. Second, the standard ablation parameter of MPL was not uniform. Therefore, a more appropriate ablation parameter such as power, time, and inter-point distance needs to be investigated. Third, more clinical studies are required to confirm the efficacy and safety of the MPL ablation in LAPW isolation. Currently, a multicenter randomized controlled trial (ChiCTR1800015747, Chinese Clinical Trial Registry) is in the recruiting status.