Catheter ablation
The radiofrequency parameters were set at a temperature of 43 °C and a
power of 40 W for the anterior LA wall and 30 W for the posterior LA
wall.12 If PV isolation was not accomplished by the
creation of circumferential lesions at the antral level, cautious
remapping to detect gaps with a Pentaray catheter with the CONFIDENSE
mapping module was performed. If a gap was identified along the initial
encircling lesion, additional radiofrequency application at the same
power setting was deployed. If PV isolation was not achieved even after
ablation at the antral level, repetitive electroanatomical mapping with
the CONFIDENSE mapping module was performed. If the earliest potential
was recorded at the carina region, 15–20 W radiofrequency application
was performed to the carina while fluoroscopically observing the
movement of the right diaphragm to prevent phrenic nerve palsy.