Anticoagulation Protocol
All patients in the pre-and post-COVID epochs were treated with a minimally interrupted anticoagulation strategy. Patients treated with warfarin continued uninterrupted therapy throughout the ablation period. Patients treated with direct oral anticoagulants (DOACs) underwent cessation of anticoagulation for 12–24 hours prior to the ablation procedure, with resumption 4 hours post-procedure. Adherence to a prescribed anticoagulation regimen was assessed by international normalized ratio (INR) for warfarin-treated patients or by verbal confirmation (for NOAC-treated patients) pre-and post-procedure. During the ablation procedure itself, activated clotting time levels were maintained above 350s with intravenous heparin during LA access. Anticoagulation was continued for a minimum of 3 months following the ablation procedure for all patients unless contraindicated.