Limitation
This report has several limitations. First, this study had a very small
sample size. A large population should be assessed. Second, AF
recurrence was not assessed using a loop recorder; thus, less AF cases
might have been detected. Third, selection bias is possible. The choice
of RFA or CBA was based on the anatomical characteristics found on CT
scans. Patients who received RFA might have a more complex anatomy.
Fourth, in the RFA group, several patients underwent CA using a received
non-contact force catheter, which might have led to a higher AF
recurrence. After CBA was accepted in Japan, our hospital started to
frequently use CBA. The patients in the RFA group tended to be treated
at an earlier time. Fifth, the use of AAD after CA was based on the
physician’s discretion with or without a documented ATA. Finally, 95%
patients in the RFA group received CTI, but this ablation was not
performed because of an expected beneficial effect on preventing AF
recurrence.20