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