Main findings
This is the first study to show the significance of the positional
relationship between the EC site and right-sided anterior PVI line in
successful PVI. We report the following findings: (1) In high-density LA
mapping before ablation, an EC between the right-sided PV and RA was
observed in 23/74 patients (31%); (2) In the on-the-line and
outside-line groups, the success rate of first-pass isolation was high
(91% and 100%, respectively), while it was low in the inside-line
group (20%); and (3) Even in the presence of an EC, PVI could be
successfully achieved without additional carina ablation by
intentionally setting isolation lines.