Radiofrequency ablation procedure
All procedures were performed according to standard of care and current guidelines. Patients were under efficient stable oral anticoagulation for at least four weeks with no interruption prior to ablation. Contrast cardiac computed tomography or transesophageal echocardiography was performed the day before the procedure to rule out intracardiac thrombus. All patients underwent ablation under mild or deep assisted sedation or general anaesthesia. After venous femoral access, intravenous heparin was infused targeting an activated clotting time (ACT) >300 s. ACT was tested every 30 min, and additional heparin was applied if necessary. Trans-septal puncture was performed by standard technique under fluoroscopy and transoesophageal echocardiography guidance when needed. Electroanatomic mapping was completed using IntellaMap Orion™. Radiofrequency (RF) ablation was performed with standard 4-mm-tip irrigated catheter (Celsius Thermocool™, Biosense Webster; Blazer OI™, Boston Scientific), magnetic irrigated catheters (IntellaNav OI™, Boston Scientific) or with contact force sensing irrigated catheters (Tacticath™, St. Jude Medical). PVI was achieved using a wide circular antral linear lesion. Additional lesion sets including linear lesions and ablation of complex fractionated atrial electrograms for persistent AF procedures were performed at the physician’s discretion. For AT, ablation targeted the critical isthmus or the area of focal origin.Pulmonary veins entrance and exit blocks, as well as bidirectional blocks for linear lesions were confirmed by conventional pacing and/or activation mapping. After procedure completion, the patient was monitored in the recovery unit then discharged 24 to 48 hours later after clinical examination, ECG and transthoracic echocardiography. .