Limitations:
This single-operator non-randomized study retrospectively evaluated procedural parameters from a small patient population, which limited the statistical power of the analyses. While a consecutive series of patients undergoing first-time ablation was selected, BMI and female population were higher in the SureFlex group, which may have introduced procedural complexity and technical challenges. The operator was not blinded to the sheath being used; however, similar mean CF achieved using both sheaths is indicative of a lack of operator bias. Furthermore, limited follow-up information was available due to the small patient cohort. Larger randomized studies involving multiple operators and longer patient follow-up are needed to validate these findings and understand the effects of CF stability on procedural outcomes. Other commercially available sheaths, as well as the contribution of different ablation catheters, can also be explored to optimize CF stability.