Discussion
The major findings of this study are as follows. WTs in the area surrounding the PV, evaluated by ICE, were heterogenous and varied among patients. In addition, real-time WT measurement and WT-based AI-adjustment in each patient increased success rate of first-pass isolation, decreased residual gap/PV potentials after a circular RF application, and decreased the time to complete PVI. Finally, TAI showed a higher 1-year AF-free survival rate than FTI. We first conducted real-time ICE measurement of the LA WT for PVI and then performed WT-based AI adjustment in each anatomical segment. Effective use of AI technology based on the precise RF target could improve the efficacy of PVI.