Limitations
This is a single-center nonrandomized study and has the inherent
limitations of this design, matching our scope of a first-in-man
feasibility and effectiveness report. Despite the small number of
patients enrolled, the study was sufficient to observe significant
differences in arrhythmic outcomes between groups. Furthermore, the
small sample size might account for the failure to detect differences
between groups in all the QoL scores.
We may also have underestimated the recurrence rate because of
asymptomatic undocumented arrhythmia episodes. However, many prior
studies of AF ablation have not systematically looked for asymptomatic
episodes of recurrent atrial fibrillation on a daily basis. Finally,
percutaneous ablation was performed 2 to 6 weeks after the surgical
approach, and in some cases full ‘maturation’ of the surgical scars may
had not happened.