Local epicardial robotic-enhanced hybrid ablation efficacy predictors for persistent atrial fibrillation

Figures

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  Figure 1. Example of complete signal dropout after radiofrequency (RF) application. Electrograms (EGMs) before (top) and after (bottom) effective energy application are shown.

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  Figure 2. Impedance trend with the first seconds of radiofrequency application. Mean impedance trends during acute effective local epicardial radiofrequency ablation (ELRF) and without ELRF lesions are shown. Bars indicate 95% confidence interval limits. Inset: Unstable impedance drop (ie, a gradual increase after an initial drop) within the first seconds in the without ELRF lesions.

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  Figure 3. Receiver operating characteristic curve analyses for the single component of the predictive score and the composite score model (A) and the validation dataset score (B).Green indicates the predictive score. Red indicates impedance drop (ID) at 8 seconds. Magenta indicates ID at 1 second. Blue indicates baseline impedance. AUC = area under the receiver operating characteristic curve.

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  Figure 4. Proposed predictive score for identifying effective local epicardial radiofrequency ablation (ELRF) is analyzed. Analyses of baseline impedance (BI) and impedance drop (ID) at 1 and 8 seconds using the proposed score are shown. The probability of ELRF based on the total score is categorized as follows: 4 = high; 3 = moderate; ≤2 = low. In cases with score ≤2, it is advisable to stop RF application because it has a poor efficacy. RF = radiofrequency.

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  Figure 5. A: Bar plot comparing the area under the receiver operating characteristic curve (AUROC) for the single component and composite score models between the training and test groups (P value calculated using the DeLong test). B: Violin plot displaying the probability of acute effective local epicardial radiofrequency ablation (ELRF) for each score obtained.

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  Figure 6. Same examples of impedance profile, in the left side (A–C) good energy application with LRFE, in the right side (D–F) not LRFE. LRFE = acute local RF ablation efficacy.