Figure 1. Study design and flowchart
AF = atrial fibrillation, LGE = late-gadolinium enhancement
Figure 2. Definition of the PLS
A: patchy and dense LGE pattern. B: 3D LGE-MRI fused with CE-MRA. Lower panel depicted the patchy and dense LGE sites. Of note, ablation targets were the patchy LGE sites but the dense one. MA = mitral annulus, LGE-MRI = late-gadolinium enhancement magnetic resonance imaging, CE-MRA = contrast enhancement magnetic resonance angiography
Figure 3. Distribution of the PLS
The left and right panels illustrated the distribution of the PLS in the posterior-anterior view and anterior – posterior view. The PLS was predominantly found around PV antrum and LAA base.
PLS = patchy late-gadolinium enhancement site, PV = pulmonary vein, LAA = left atrium appendage
Figure 4. Kaplan-Meier curve of freedom from AF/AT for each group
AF = atrial fibrillation, AT = atrial tachycardia, PLS = patchy LGE site
Figure 5. PLS ablation in the representative case
A: The left panel showed the LGE-MRI. The right panel showed the 3D LGE-MRI fused with CE-MRA using by specially customized software. The white arrow and red dotted circle indicated the PLS around LAA base.
B: RF application at the PLS by using NavX system. The light blue electrogram indicated the atrial signal recorded by the ring catheter in the LAA. The LAA electrograms were organized and terminated during RF application. The 3D tags indicated the RF application points. The yellow one indicated AF termination points.
LGE-MRI = late-gadolinium enhancement magnetic resonance imaging, CE-MRA = contrast enhancement magnetic resonance angiography, PLS = patchy LGE site, LAA = left atrial appendage, RF = radiofrequency