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Figure 1. Representative image of ablation index-guided high-power
atrial fibrillation catheter ablation under Carto-Sound system.
Figure 2. Step-by-step illustration of FLAVOR approach. LAA, left atrial
appendage; P, posterior; R, right; A, anterior; PA, posteroanterior;
LSPV, left superior pulmonary vein; LIPV, left inferior pulmonary vein.
Figure 3. Illustration of ICE with FLAVOR approach to measure LAA
orifice and landing zone and to assess the position of the device and
residual flow at four angles (90°, 135°, 0°, and 45°). Expanded view of
LAA orifice and ICE planes at 90° (A), 135° (G), 0° (M), and 45° (S).
Posteroanterior (B, H, N, T) and left lateral views (C, I, O, U) of
three-dimensional reconstruction of the left atrium and the
corresponding position of the ICE catheter are shown. Measurement of the
LAA orifice and landing zone (D, J, P, V) and assessment of the device
position and residual flow (E, K, Q, W) using ICE with long-axis views
at the four angles after release are also depicted. Pre-procedural TEE
views of the LAA at 90°, 45°, 0°, and 135° (F, L, R, X) were similar to
the ICE views at 90°, 135°, 0°, and
45° (D, J, P, V). LAA, left atrial appendage; ICE, intracardiac
echocardiography. TEE, transesophageal echocardiography.
Figure 4. Residual peri-device flow detected by ICE-guided FLAVOR
approach after LAmbre LAA device detachment. Color Doppler evaluation of
the residual peri-device leakage in 0°, 45°, 90°, and 135° views of ICE
images with LAmbre LAA device using FLAVOR approach (A–D). ICE,
intracardiac echocardiography; LAA, left atrial appendage.
Figure 5. Observed stroke and bleeding rates during follow-up versus
expected annual stroke and bleeding risk.