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.