Catheter ablation procedure
Patients with paroxysmal AF routinely underwent circumferential pulmonary vein isolation (CPVI). In nonparoxysmal AF patients, the STABLE-SR strategy was used to target the fibrotic areas; this strategy has been well described and was previously published.24 In brief, all nonparoxysmal AF patients underwent CPVI and cavotricuspid isthmus (CTI) ablation. Then, we performed electrical cardioversion to restore sinus rhythm. An A-Focus catheter (St. Jude Medical, St Paul, MN) was used to generate a high-density bipolar map of the left atrium. In the low-voltage zone, all tissue was homogenized. In the transitional zones, complex electrograms were eliminated. Dechanneling line was performed if necessary. If AF continued after cardioversion, we performed linear ablation, including the left atrium roof line and the mitral isthmus line. Ablation of complex fractional electrograms was performed to terminate AF if necessary.