4.2 Interventional outcome
In our series, we had a satisfactory acute success rate (~96%) in achieving complete MI block. Probably, our systematic approach with the steerable sheath support, the continuous maintenance of sufficient catheter contact force (>15g) and the accuracy of the 3D imaging - there were no patient movements due to general anesthesia - contributed to this high percentage [23]. However, as shown by other studies [24], there will always be a considerable group of patients in whom we cannot achieve complete MI block with the available technological means. Thus, in our study, if we add the percentage of interventional failure (4.2%) and the percentage of patients presenting with PMF and MI pseudo-block (6.9%) we reach an 11.1%. These patients have a higher likelihood to develop PMF even if this arrhythmia is not pre-existing, a fact that we need to take into consideration when we intend to perform the MI line [14-16]. Presumably, reinduction attempts should be performed only to exclude PMF induction after each successful MI ablation. On the contrary, the reinduction of AF, despite some relatively contradictory data [25], does not seem to be a predictor in maintaining SR [26]. In our study, we also found that MI ablation is a time-consuming procedure with the mean pure ablation time being almost 11 minutes, something that we must always take into account for the preparation of the procedural plan.