Additional ablation for first PVI and acute reconnection
In total, 15/51 (29.4%) and 9/23 (39.1%) of the patients in the EC-negative and EC-positive groups, respectively, failed first-pass isolation. Of these patients, the most common success site of PVI was the anterior carina, observed in 7/15(46.7%) of the patients in the EC-negative group and in 7/9 (77.8%) of the patients in the EC-positive group. In the EC-positive group, the concordance rate between success and EC sites was higher in the inside-line group than that in the online group (7/8, 88% vs. 0/1, 0%; p=0.0472).
There were no significant differences in the rate of acute reconnection during the procedure between the groups. The acute reconnection sites were widely distributed, including an EC site in the inside-line group. Despite achieving first-pass isolation in the inside-line group, one of the two patients required additional ablation at the EC site because of acute reconnection.
The need for additional carina ablation for the first PVI and acute reconnection was not significantly different between the EC-negative and EC-positive groups (9/51,17.7% vs. 8/23, 34.8%; p=0.1377). However, among the patients in EC-positive group, additional carina ablation was required significantly more frequently in the inside-line group than in the online or outside-line groups (8/10, 80% vs. 0/11, 0% vs. 0/2, 0%; p<0.001).
Finally, all the right-sided PVs were successfully isolated. No major complications, such as cardiac tamponade or stroke, occurred.