Figure Legends
Figure 1. Atrial fibrillation ablation with EpicorTMhigh-intensity focused ultrasound aims to create a box isolation around
the four pulmonary veins. Herefore, an ultraclinch device is placed
around the pulmonary veins, and closed in front of the right superior
pulmonary vein (A). Accordingly, the voltage map of the left atrium
reveals a line of low-voltage zones around the pulmonary veins that
represent the EpicorTM ablation line (A+B). However,
there are multiple gaps along the line, particularly among the anterior
segments of the right pulmonary vein (A, RAO projection), and among the
posterior wall (B, PA projection). Abbreviations: LIPV = left inferior
pulmonary vein; LSPV = left superior pulmonary vein; PA = posterior
anterior; RAO = right anterior oblique; RIPV = right inferior pulmonary
vein; RSPV = right superior pulmonary vein.
Figure 2. Activation (A) and coherent mapping (B) of the left atrium
demonstrate a focal activation pattern of the atrial tachycardia. The
tachycardia originates from a gap in the EpicorTMablation line (*), which is located right at the transition to the left
atrial appendage (colored in blue). In the coherent map, zones of slow
or no conduction are colored in brown. The corresponding intracardial
signals at the earliest activation site are shown in the bipolar
derivative MAP 1-2 and the unipolar derivative MAP 1, respectively.
Abbreviations: LAA = left atrial appendage; LIPV = left inferior
pulmonary vein; LSPV = left superior pulmonary vein; RIPV = right
inferior pulmonary vein; RSPV = right superior pulmonary vein.
Figure 3. The EpicorTM line was completed by ablation
points at the posterior wall and the anterior segments of the right PV.
After ablation, the voltage map of the left atrium confirms the
successful isolation of all pulmonary veins and the posterior wall (A,
RAO projection; B, PA projection). Abbreviations: LIPV = left inferior
pulmonary vein; LSPV = left superior pulmonary vein; PA = posterior
anterior; RAO = right anterior oblique; RIPV = right inferior pulmonary
vein; RSPV = right superior pulmonary vein.