{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T22:20:38Z","timestamp":1784931638027,"version":"3.55.0"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ablation index (AI) linearly correlates with lesion depth and may yield better therapeutic performance in pulmonary vein isolation (PVI) when tailored to a patient's wall thickness (WT) in the left atrium (LA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>First study: In paroxysmal atrial fibrillation patients (PAF; <jats:italic>n<\/jats:italic>\u2009=\u200920), the average LA WT (mm) in each anatomical segment for PVI was measured by intracardiac echocardiography (ICE) placed in the LA; the optimal AI for creating 1\u2010mm transmural lesion (AI\/mm) was calculated. Second study: PAF (<jats:italic>n<\/jats:italic>\u2009=\u200980) patients were randomly assigned either to a force\u2010time integral protocol (FTI; 400\u2009g\u00b7s, <jats:italic>n<\/jats:italic>\u2009=\u200940) or a tailored\u2010AI protocol (TAI; <jats:italic>n<\/jats:italic>\u2009=\u200940). In TAI, the LA WT in each segment was individually measured by ICE before starting ablation; a target AI was adjusted according to the individual WT in each segment (AI\/mm\u2009\u00d7\u2009WT). The acute procedure outcomes and the 1\u2010year AF\u2010recurrence rate were compared between FTI and TAI. TAI had higher success rate of first\u2010pass isolation (88% vs. 65%) and had lower incidence of residual PV\u2010potentials\/conduction\u2010gaps after a circular ablation than FTI (15% vs. 45%). The procedure time to complete PVI decreased in TAI compared to FTI (52 vs. 83\u2009min), being attributed to the increased radiofrequency power and the decreased radiofrequency application time in each point in TAI. TAI had a lower 1\u2010year AF\u2010recurrence rate than FTI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TAI increased acute procedure success, decreased time for PVI, and reduced the 1\u2010year AF\u2010recurrence rate, compared to FTI. Understanding the precise ablation target and tailoring AI would improve the efficacy of PVI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15000","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T08:04:20Z","timestamp":1615449860000},"page":"1620-1630","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Wall thickness\u2010based adjustment of ablation index improves efficacy of pulmonary vein isolation in atrial fibrillation: Real\u2010time assessment by intracardiac echocardiography"],"prefix":"10.1111","volume":"32","author":[{"given":"Yuji","family":"Motoike","sequence":"first","affiliation":[{"name":"Department of Cardiology Fujita Health University  Toyoake Aichi 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