Feasibility and safety of a novel very-high-power short-duration ablation strategy for superior vena cava isolation

Figures

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  Figure 1. Flow diagram of the study. AF = atrial fibrillation; MPMD = middle-power middle-duration; SVCI = superior vena cava isolation.

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  Figure 2. 3-dimensional anatomic mapping images of the SVC. A: Anteroposterior view. The white line shows the roof level of the LA. B: Short-axis image at the white line from the cranial view is divided into the following 8 segments: anterolateral, lateral, posterolateral, posterior, posteromedial, medial, anteromedial, and anterior. The first 3 segments, which may capture the phrenic nerve during pacing, are defined as the lateral segment, whereas the last 5 are defined as the nonlateral segment. LA = left atrium; RSPV = right superior pulmonary vein; SVC = superior vena cava.

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  Figure 3. 3-dimensional electroanatomic mapping images of SVC isolation. Circumferential SVC isolation was performed with an interlesion distance of 5–6 mm and a tag size of 6 mm. The standard isolation line was set at the roof level of the LA. A: The radiofrequency (RF) settings in the 70 W group were 70 W for 4 seconds with a contact force (CF) of 5–20 g for the lateral and nonlateral segments. B: The RF settings in the 30–40 W group were 30 W, CF 5–10 g, and a target AI of 300–350 for the lateral segment and were 30–40 W, CF 5–20 g, and a target AI of 350 for the nonlateral segment. AI = ablation index; LA = left atrium; SVC = superior vena cava.