2.6 Radiofrequency ablation for atrial fibrillation
In patients with combined procedures, radiofrequency ablation was
performed prior to LAAC. An additional decapolar catheter was placed in
the coronary vein through the left femoral vein access in patients with
combined procedure. In ICE group, ICE was used to create a LA anatomical
map in the right atrium. Single transseptal puncture was guided by ICE.
An ablation catheter (Thermocool SmartTouch, Biosense Webster, Inc)
supported by a steerable sheath (Agilis NXT; St. Jude Medical, St Paul,
MN, USA) was used to perform ablation index guided circumferential
pulmonary vein isolation. In patients with persistent atrial
fibrillation, cardioversions were delivered to restore sinus rhythm
after CPVI. Substrate mapping and ablation then was performed as
previously described7. In TEE group, following double
transseptal punctures, the LA anatomical map was created using a 10-pole
spiral catheter (Lasso NAV, Biosense Webster, Inc.) under Carto3
mapping
system guidance. The ablation strategy was similar in the ICE group.