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.