Limitations
We acknowledge several limitations in our study. First, we have only one
RCT included in our meta-analysis while the rest were non-randomized
comparative studies. Although, all included studies were of good quality
based on NewCastle Ottawa scale, reflecting a real-world experience,
more randomized controlled trials would provide better evidence for the
difference in outcomes between two groups. Second, there were variations
in each study in terms of power, types of catheters, contact force,
target temperature, and the definition of freedom from atrial
arrhythmia, resulting in significant heterogeneity between groups. And
seldom included studies analyzed total energy during ablation procedure
which we could not compare between two groups. Third, on account of
included studies not only performed PVI but also additional linear
ablation, different surgical methods might affect the maintenance of
sinus rhythm. At last, we have a limited number of studies that reported
PVR during redo procedures and with the guidance of AI/LSI. Finally,
exact anatomical locations of PVR were not clearly described in each
study, so we could not analyze the specific locations of PVR.