Figure Legends
Figure 1. Schematic diagram of the study protocol.Target AI in FAI was based on our previous retrospective study. Target AI in TAI was calculated in each patient by the formula as follows: target AI in a segment = 90 (AI/mm) × individual WT (mm) in each segment. AI, ablation index; ICE, intracardiac echocardiography; PV, pulmonary vein; WT, wall thickness.
Figure 2. Biplane fluoroscopic images of ICE manipulation in the LA. (A) Contrast-enhanced fluoroscopic image of the LA. AP view. (B) LAO 60° view. (C) ICE manipulation under fluoroscopic guidance. AP view. (D) LAO 60° view. AP, anterior-posterior. ICE, intracardiac echocardiography. LAO, left anterior oblique.
Figure 3. Representative snapshots of ICE imaging. (A) ICE images of the roof (upper left), bottom (upper middle), and posterior (upper right) segments in the left-PV (LPV). The direction of ultrasound beam (left) and the corresponding snapshot of ICE imaging (right) are shown in each segment. Red arrows indicate the measurement of wall thickness (WT). (B) ICE images of the anterior (lower left), roof (lower middle), and bottom (lower right) segments in the right-PV (RPV). Ao, aorta; HRA-CS, high right-atrium-coronary sinus; LA, left-atrium; LPA/RPA, left/right pulmonary artery; LSPV/LIPV, left superior/inferior pulmonary vein; RSPV/RIPV, right superior/inferior pulmonary vein; SVC, superior vena cava.
Figure 4. Representative ICE images of the anterior segment in the left-PV (left lateral ridge, LLR) . The direction of ultrasound beam (left) and the corresponding snapshot of ICE imaging (right) are shown in each patient. Patient #3 had a left common PV. AV, aortic valve; LAA, left atrial appendage; LSPV/LIPV, left superior/inferior pulmonary vein.
Figure 5. Average WT and target AI in each segment for PVI in TAI. AI, ablation index; LPV, left pulmonary vein; RPV, right pulmonary vein; WT, wall thickness.
Figure 6. Comparison of procedure characteristics between FTI and TAI. (A) Mean±SD success rate of first-pass isolation. Open column indicates FTI and solid column does TAI. (B) Mean±SD prevalence of residual PV potential/conduction gap after a circular RF application. (C) Mean±SD incidence of spontaneous PV reconnection/drug-evoked dormant conduction. (D) Mean±SD RF ablation time to complete PVI. n.s., not significant. *p<0.05 vs. FTI.
Figure 7. Kaplan-Meier AF-free survival curve in FTI and TAI