Repeat ablation
At repeat ablation, CHADS2 and CHA2DS2-VASc scores increased significantly and there was an improvement in LVEF (Table 2). TEE and contrast-enhanced CT imaging were performed in 356 (58%) and 408 patients (66%), respectively. Twenty-three patients refused to undergo TEE at the repeat ablation, mostly due to the difficulty in swallowing the probe, but all patients underwent some alternative imaging examination. A total of 476 patients (77%) underwent at least one imaging modality to evaluate LA thrombi before the repeat procedure. One hundred and eighteen patients (19%) had an interruption of oral anticoagulants before the repeat session, and 142 patients (23%) exhibited a non-paroxysmal atrial arrhythmia after the first ablation. Changes in coagulation markers and TEE findings from the first to the repeat ablation are shown in Table 3. At the repeat ablation, 72 patients switched from warfarin to DOAC, while six patients switched from DOAC to warfarin. Three patients (0.8% in TEE and 0.5% in repeat ablation) developed LA thrombi seen on TEE at the repeat procedure. In contrast, one patient had a thromboembolic event after the repeat ablation procedure without prior TEE evaluation.