Radiofrequency ablation for AF
In patients with the combined procedure, radiofrequency ablation was
performed before LAAC under conscious sedation, with fentanyl and
midazolam for pain relief. Following double transseptal punctures, a
left atrial (LA) anatomical map was created using a 10-pole spiral
catheter
(Lasso
NAV; Biosense Webster, Inc., Diamond Bar, CA) under the guidance of a
three-dimensional electroanatomical mapping system (CARTO 3; Biosense
Webster, Inc.). A contact-force catheter (Thermocool SmartTouch;
Biosense Webster, Inc.) was used to perform ablation index-guided
circumferential pulmonary vein isolation with target values (450 for the
anterior wall and 350 for the posterior wall). The endpoint of ablation
was bidirectional conduction block between the left atrium and pulmonary
veins. In patients with persistent AF, cardioversions were delivered to
restore sinus rhythm after circumferential pulmonary vein isolation.
Substrate modification was then performed as previously
described15.