Peri-procedural management
Pre-procedure TEE was performed only for the patients presenting in AF at the time of ablation as per institutional practice. All patients underwent a preprocedural computed tomography (CT) scan to assess the left atrium (LA) and pulmonary vein (PV) anatomy in detail. Catheter ablation in patients on warfarin was performed without cessation of warfarin, and patients on direct oral anticoagulants (DOACs) held anticoagulation for 12–24 hours prior to the ablation procedure, with resumption 4 hours post-procedure. Anticoagulation was continued for a minimum of 3 months following the ablation procedure for all patients unless contraindicated.