Study design and population
This study was a single-center retrospective observational study. We enrolled consecutive patients who underwent a first-time radiofrequency CA of AF with the CARTO3 navigation system (Biosense Webster, Diamond Bar, CA, USA) at Osaka Rosai Hospital between September 2014 to August 2019. The exclusion criteria were (1) patients whom we could not follow up for at least 3 months and (2) patients with no available pre-procedural echocardiograms or laboratory data.
We divided these patients into the two groups: patients who underwent an AI-guided PVI (AI group) and those who underwent a CF-guided PVI (CF group). Propensity score matching (PSM) was used to adjust for the patient age, sex, body mass index (BMI), body surface area (BSA), type of AF (paroxysmal or non-paroxysmal), history of heart failure, hypertension, diabetes and strokes, laboratory findings including the estimated glomerular filtration rate (eGFR) and B-type natriuretic peptide (BNP), and echocardiography parameters including the left ventricular ejection fraction (LVEF) and (left atrium) LA diameter. After the PSM, we compared the incidence of ERATs and late reconnection rate of isolated PVs during second session between AI and CF groups. Additionally, we performed univariate and multivariate analyses to examine the clinical factors correlated with the incidence of ERAT.
This study was approved by the local ethics committee (approved number: 2020-29). All patients gave their informed consent for the CA procedure.