Design and inclusion/exclusion criteria
We conducted a single-center, prospective, observational study at the
Arrhythmology Unit of the Mediterranea Center, Naples, Italy, enrolling
consecutive patients with symptomatic persistent or longstanding
persistent AF, who were referred for endo-/epicardial CA after at least
one prior endocardial procedure. Exclusion criteria included prior
cardiac surgery or other pericardial diseases predisposing to
pericardial adhesions.
The study was carried out according to institutional standards, national
legal requirements, and the Declaration of Helsinki. Informed consent
was obtained from all patients. Being an observational study, approval
of the ethics committee was waived.