Study population
The study population was retrospectively analyzed and originated from a
database of patients who underwent catheter ablation for AF at Nagoya
University Hospital, Japan. All patients who were scheduled to undergo
catheter ablation for AF which involved the LA at our center from
January 2007 to July 2021 were included in the study. Patients with a
history of MAZE procedure and thrombi formation prior to the initial
session and with major adverse events during the first session were also
included in the study. The exclusion criteria were as follows: detection
of thrombi at the first session; and undergoing ablation for the right
atrium only. We reviewed the medical records, examination data, and
procedures in the databases of all eligible patients. The indications
for catheter ablation complied with the most recent
guidelines.3 Antiarrhythmic agents were discontinued
at least five half-lives before ablation. Informed consent for the
procedure was obtained from all patients. The study protocol was
approved by the institutional ethics committee. The study was performed
in accordance with the principles of the Declaration of Helsinki.