Intracardiac echocardiography improves lesion quality and ablation efficiency of pulmonary vein isolation in atrial fibrillation patients: a propensity score-matched analysis

Figures

• 

  Figure 1. Typical images of catheter ablation of atrial fibrillation with ICE. (A) “Tent sign”: Atrial septum being tented by the tip of the transseptal puncture needle. (B) “Bubble sign”: As the puncture needle passes through the atrial septum, “tent sign” disappears and the infusion of saline reveals the “bubble sign” in the left atrium. (C) Ablation points recorded by Visitag system combined with atrial three-dimensional anatomical shell guided by ICE and CARTO3 system.

• 

  Figure 2. An example of AIFV results of AF patients after CA. The AIFV system will independently evaluate each ablation point in pulmonary vein (PV) circles, including inter-lesion distance, percentage of lesions with effective force-over-time (FOT ratio), percentage of lesions with effective AI (AI ratio), radiofrequency time, etc., and finally present the results in the form of a hexagonal radar chart.

• 

  Figure 3. Comparison of six AIFV parameters between ICE and No-ICE groups. Violin plots show median values with 25th and 75th percentiles for (A) total PVI time (seconds), (D) PVI time of LPV (seconds), (G) PVI time of RPV (seconds), (B) break point ratio (%), (C) gap number, (E) RF time ratio for LPV (%), (F) FOT ratio for LPV (%), (H) RF time ratio for RPV (%), and (I) AI ratio for RPV (%). (J) Radar chart of six AIFV parameters. Statistical significance denoted by *p < 0.05, **p < 0.01, ***p < 0.001. AI, ablation index; FOT, force over time; LPV, left pulmonary vein; PVI, pulmonary vein isolation; RF, radiofrequency; RPV, right pulmonary vein.

• 

  Figure 4. Kaplan–Meier survival curve for freedom from AF recurrence (in months) over 12 months post-PVI in ICE and No-ICE groups. (A) Overall survival analysis for both groups. (B) Subgroup analysis for persistent AF. (C) Subgroup analysis for paroxysmal AF.