Follow-up after the ablation
Patients were followed up periodically in an outpatient clinic. They were evaluated for episodes of AF recurrence or atrial tachycardia (AT) based on regular 12-lead electrocardiograms at 1, 4, 7, 10, and 13 months after the ablation. An event recording (Spiderflash-TTM; Japan Lifeline, Tokyo, Japan) was performed at 3, 6, and 12 months after the ablation. Patients were also periodically followed up in our institute or clinics. AF lasting >30 s on these recordings after a 3-month blanking period was evaluated as a recurrence. AADs were resumed after the ablation and discontinued if recurrent AF or AT was not documented by an event recording obtained at 3 months after the ablation. Patients who originally had not taken AADs were followed up without taking AADs. AADs were commenced, or changed to amiodarone or bepridil, if recurrent AF or AT was documented on these recordings. The subsequent ablation process proceeded if AF or AT was refractory to medical therapies. In the next session, bidirectional MI block was confirmed by differential pacing maneuver as well as the first ablation session.