Lesion Index–guided workflow for the treatment of paroxysmal atrial fibrillation is safe and effective – Final results from the LSI Workflow Study

Figures

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  Figure 1. Lesion Index (LSI)–guided ablation using the EnSite System (Abbott). (Left) Voltage map created pre-ablation. (Middle) AutoMark lesions displayed using color settings according to achieved LSI (light pink ≥3.0, magenta ≥4.0, red ≥5.0). Real-time LSI is displayed on the EnSite system during ablation. (Right) Voltage map created post-ablation.

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  Figure 2. A: Reference points for the location of zone borders around the left (shaded circles A–D) and right (shaded circles E–H) pulmonary veins (PVs). Circle A: LSPV roof and anterior border; circle B: LSPV roof and posterior border; circle C: LIPV floor and posterior border; circle D: LIPV floor and anterior border; circle E: RSPV roof and posterior border; circle F: RSPV roof and anterior border; circle G: RIPV floor and anterior border; circle H: RIPV floor and posterior border. B: Numbered anatomical zones around the PVs. LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; RIPV = right inferior pulmonary vein; RSPV = right superior pulmonary vein.

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  Figure 3. Identified gaps, target Lesion Index (LSI), and achieved LSI by anatomical region. A: The number of subjects with gaps identified in each defined pulmonary vein region is noted. Note that in 3 subjects gaps were identified but unable to be isolated. Subjects may have experienced a reconnection in more than 1 zone. B: For each defined pulmonary vein region displayed in panel A, the mean ± standard deviation target LSI, the mean ± standard deviation achieved LSI, and the mean ± standard deviation minimum achieved LSI per subject for first-pass isolation (no gaps identified in the zone) are displayed. Target LSI, the desired LSI value for each lesion, was defined by the operator for each region in each subject. Achieved LSI for each lesion was included in the AutoMark data. Postprocedure, each lesion was categorized into a defined region. Abbreviations as in Figure 2.

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  Figure 4. Lesion-level characteristics. The mean and standard deviation for contact force, average power, and duration are included for each subgroup analyzed. LSI = Lesion Index.

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  Figure 5. Touch-up ablations. The number of subjects with pulmonary vein touch-up ablations performed during the index procedure, evaluated for each subgroup: by geography (bottom), by mean achieved Lesion Index (LSI) (middle), and by high or standard average power (top).