8 f sl0 sheaths

We discontinued all antiarrhythmic drugs for, at least, 5 half‐lives, and no patient received oral amiodarone before ablation. Moreover, antiarrhythmic drugs were not resumed after ablation. We used the NavX System (St. Jude Medical Inc., St. Paul, MN) for ablation. The esophageal temperature monitoring system (SensiTherm, St. Jude Medical, Inc.) was used to provide intra‐esophageal temperature feedback. Sheath introducers were inserted through the right femoral vein under sedation. We performed the trans‐septal procedure and advanced three 8‐F SL0 sheaths (St. Jude Medical, Inc.) or two 8‐F SL0 sheaths and a steerable sheath (Agilis, St. Jude Medical, Inc.) into the left atrium. After the trans‐septal puncture, a single bolus of 5000 U of heparin was administered. A continuous infusion with heparinized saline was performed to maintain an activated clotting time of 300‐350 seconds. Pulmonary vein isolation was performed with 3D mapping and guidance using two 7‐F decapolar circular catheters (Lasso and Libero), which were positioned at the ipsilateral pulmonary vein ostia. The procedure was completed with cavotricuspid isthmus ablation. Each radiofrequency application was performed for 30‐50 s, the temperature was limited to 42°C and power to 30 W. We used the maximum power of 25 W while delivering energy to sites near the esophagus.

The NavX system (NavX with CFE software, St. Jude Medical Inc., St. Paul, MN, USA) was used for catheter ablation. A 5-F deflectable catheter was inserted into the coronary sinus (CS) via the right femoral vein. The trans-septal procedure was performed using fluoroscopic landmarks, and three 8-F SL0 sheaths (St. Jude Medical Inc.) were advanced into the left atrium (LA). After the trans-septal procedure, a single bolus of 5000 U of heparin was administered. A continuous infusion with heparinized saline was administered to maintain an activated clotting time of 300–350 s. The 3-dimensional biatrial geometry was created on the NavX system, and sequential contact mapping was performed using a 7-F decapolar circular catheter (Lasso, Biosense-Webster, Inc., Diamond Bar, CA, USA). The points in each region were similar in number and nearly equally distributed. The mapping was performed during AF.

A NavX system (St. Jude Medical Inc., St. Paul, MN) was used for catheter ablation. A 5‐french deflectable catheter was inserted into the coronary sinus (CS) via the right femoral vein. The trans‐septal procedure was performed using fluoroscopic landmarks, and three 8‐F SL0 sheaths (St. Jude Medical, Inc.) were advanced into the LA. After the trans‐septal procedure, a single bolus of 5000U of heparin was administered. A continuous infusion with heparinized saline was delivered to maintain an activated clotting time of 300 to 350s. The 3D biatrial geometry was created on the NavX system, and sequential contact mapping was performed using a 7‐F decapolar circular catheter (Lasso, Biosense‐Webster, Inc., Diamond Bar, CA). The LA was divided into nine areas (pulmonary veins [PVs], roof, left atrial appendage [LAA], LA septum, lateral, anterior, bottom, posterior, and CS) and RA into seven (lateral, anterior, posterior, cavotricuspid isthmus, superior vena cava, inferior vena cava, and RA septum) for a location analysis of the AF substrate.5 The points in each region were similar in number and nearly equally distributed.