Limitations
Several limitations of this study need to be acknowledged. First, this
was a singleācenter retrospective study that included a limited number
of patients, which resulted in the possibility of selection bias.
Second, P-SAECG is sometimes difficult to perform because of irregular
cardiac rhythms such as atrial or ventricular premature beats,
environmental noise causing electrocardiogram interference, or overlap
between the end of the P-wave and the beginning of the QRS complex.
Third, asymptomatic recurrence during the follow-up period could not be
fully identified; therefore, the recurrence rate may be underestimated.
Fourth, the cause of AF recurrence, such as PV reconnection or other
non-PV foci, could not be identified. Finally, P-SAECG can only be
performed in patients with sinus rhythm; therefore, it might be
challenging to apply our findings to patients with non-paroxysmal AF.
Further prospective studies are needed to ascertain the relationship
between AF recurrence and ALP.