Limitations
Our study was retrospective, leading to possible confusion bias.
Nevertheless, we included all consecutive procedures in each group over
the same period of time. The choice of the Rhythmiaâ„¢ system to guide
ablation procedure was not randomized, and one could assume that our
study population should be slightly different if all procedures were
considered, regardless of the mapping system used. LVEF was not
determined by a core-lab but was retrieved from medical files. We did
not use a standardized arrhythmia recurrence diagnostic protocol and
patients with HFrEF had more implanted device allowing asymptomatic
recurrence documentation. Therefore, it would be important to address
these biases and confirm our results in a prospective manner.
Conversely, our study population is probably representative of the
real-life ablation landscape in a setting of HF, with repeated ablations
and recurrent ATs.