Catheter ablation
Catheter ablation was performed using an open-irrigated, 3.5-mm-tip
contact force-sensing ablation catheter (THERMOCOOL SMARTTOUCH, Biosense
Webster, Inc.). The radiofrequency energy output was adjusted to 25–35
W, at a flow rate of 17–30 mL/min, with a maximum temperature of 42 °C.
The contact force was targeted at 10–30 g, and a maximum threshold of
50 g was set for all cases. PVI was first performed in all patients
during AF. Additional ablations, including linear ablation, such as the
LA posterior wall isolation (LAPWI) and mitral isthmus linear block,
complex fractionated atrial electrogram (CFAE) ablation, or elimination
of drivers identified by CARTOFINDER, were applied with the end point of
termination of AF. The choice of additional ablations was dependent on
operator discretion. If AF was converted into atrial tachycardia (AT),
subsequent ablation was performed for the AT. External cardioversion was
performed in cases in which the heart rhythm of the patient did not
convert to sinus rhythm at the end of the ablation.