Study limitations
Our study has some limitations. The study was conducted in a single
center and in a limited number of patients. For an accurate assessment
of LAPW thickness adjacent to the esophagus, the image plane was
required to be perpendicular toward the posterior LA wall. We tried to
obtain such an image, but there might be a possibility of overestimation
because of an oblique projection. We used only one power setting (25W)
in AI guide ablation on the esophagus region and did not evaluate the
effect of RF power on the outcomes. No endoscopic examination was done
to detect the esophageal lesion, and asymptomatic lesion could not be
ruled out. Because AF recurrence was assessed by the symptoms and Holter
ECG monitoring intermittently, asymptomatic AF might have been
underestimated.