Limitations
Despite the encouraging result in the present study, it is limited by its non-randomized design and small sample size. And AF burden is not analyzed. We will continue to look for clinical evidence of higher quality in our ongoing randomized trial, the PROMPT-AF trial, which directly compares the efficacy of the ‘upgraded 2C3L’ procedure with PVI (NCT04497376). Meanwhile, atrial physiology was only assessed by activation pattern after ablation while pre- and post-procedural ultrasound cardiography was not routinely performed. Moreover, only 4 patients in the present study underwent a redo procedure after EI-VOM, the features of recurrent tachycardias after EI-VOM remain to be further investigated