Study limitations
For our main result — durability of the EIVM lesion —
generalizability is limited by the small sample size, although the
monocentric and consecutive enrollment and the follow-up data available
for each patient limit the risk of biased selection. Second, assessment
of scar area in the VOM region may have been limited by four main
factors: 1) inaccuracy intrinsic to the area measurement tool of the
CARTO system; 2) bipolar voltage measured in different atrial rhythms in
some patients before, immediately after, and late after EIVM, although
in a direction that may only result in underestimating the lesion size
(AF to AT/SR or AT to SR); and 3) the impact of the associated RF
lesions at the MI during the index procedure 4) absence of information
of the epicardial scar related to EIVM.
Finally, due to the accuracy of the measure, we cannot confirm that the
border of the EIVM created scar is always consistent.