Study limitations
This was a retrospective study conducted in a single center. The
decision to plan repeat ablation and the imaging modality of TEE and CT
imaging were dependent on the discretion of the attending physician and
patient condition. Although we followed medical information and clinical
events after the initial ablation in all patients as much as possible,
some unknown events and information collected at other facilities could
not be obtained from the patients’ medical records, resulting in
underestimation of the outcomes. Since periprocedural events, especially
thromboembolic events, were evaluated as those associated with any
symptom or disability, we could not assess asymptomatic embolic events
that could be evaluated in a post-procedural head magnetic resonance
imaging study. Further large-scale studies evaluating the presence of LA
thrombi using various imaging modalities at different time points after
ablation are needed.