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.