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IntroductionElectrical reconnection of the pulmonary veins (PVs) plays a key role in the recurrence of atrial fibrillation (AF) after ablative treatment. This randomized controlled study tested the hypothesis that prolonged ablations, on areas that may be critical for left atrial (LA)‐PV conduction, can significantly reduce the rate of acute PV reconnection and AF recurrence.
MethodsPatients with paroxysmal AF were randomly assigned to either a control or an add‐on group. Ostial PV isolation (PVI) was performed by point‐to‐point RF ablation (irrigated tip, 30 Watts, 30 seconds). An ostial segment was assumed to be critical for LA‐PV connection if any of the following reactions occurred during RF application: (1) sudden delay of LA‐PV conduction, (2) change of activation sequence, and (3) PVI. In this case, RF application was prolonged from 30 seconds to 90 seconds in the add‐on group only...
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