1. Volume 13, Issue 1, Pages 132-140 (January 2016)
Proven isolation of the pulmonary vein antrum with or without left atrial posterior wall isolation in patients with persistent atrial fibrillation 
Rong Bai, MD, FHRS, FESC, Luigi Di Biase, MD, PhD, FHRS, FACC, Prasant Mohanty, MBBS, MPH, Chintan Trivedi, MD, Antonio Dello Russo, MD, Sakis Themistoclakis, MD, Michela Casella, MD, Pietro Santarelli, MD, Gaetano Fassini, MD, Pasquale Santangeli, MD, Sanghamitra Mohanty, MD, FHRS, Antonio Rossillo, MD, Gemma Pelargonio, MD, Rodney Horton, MD, Javier Sanchez, MD, Joseph Gallinghouse, MD, J. David Burkhardt, MD, FHRS, Chang-Sheng Ma, MD, FHRS, Claudio Tondo, MD, Andrea Natale, MD, FHRS, FACC, FESC 
Heart Rhythm 
Volume 13, Issue 1, Pages (January 2016)
DOI: /j.hrthm
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2. Figure 1
Typical lesion set in the left atrium (LA) using different ablation techniques. A–C: A patient from group 1, pulmonary vein antral isolation (PVAI) alone. D–F: A patient from group 2, with extended PVAI down to the base of the LA and left-sided interatrial septum plus left atrial posterior wall ablation. A and D: Anteroposterior (AP) projection. B and E: Posteroanterior (PA) projection. C and F: Right anterior oblique (RAO) projection. INF = inferior; LAO = left anterior oblique; LL = left lateral; RL = right lateral; SUP = superior.
Heart Rhythm  , DOI: ( /j.hrthm )
Copyright © 2016 Heart Rhythm Society Terms and Conditions

3. Figure 2
Postablation mapping in a patient from group 2; this was the same patient as in Figure 1D–F. A and B: The lesion set for extended pulmonary vein antral isolation and left atrial posterior wall (LAPW) ablation is shown in the left column (posteroanterior view). Postablation voltage mapping (middle columns) indicated that the entire LAPW was a low-voltage area, whereas the bipolar voltage cutoff was set at 0.05 to 0.5 mV. When the circular catheter was placed on the LAPW at a different position (right columns), no near-field atrial activity was recorded, with a complete absence of electrograms demonstrating entrance block and isolation of the LAPW.
Heart Rhythm  , DOI: ( /j.hrthm )
Copyright © 2016 Heart Rhythm Society Terms and Conditions

4. Figure 3
Postablation voltage mapping in another patient from group 2. The ablation strategy applied in this patient from group 2 included extended pulmonary vein antral isolation in which the ablation was extended to the base of the left atrium at the coronary sinus level and to the left-sided interatrial septum, with additional ablations on the left atrial posterior wall. Intraprocedurally, postablation voltage mapping at different projections showed low voltage at the above-mentioned areas when the bipolar voltage cutoff was set at 0.05 to 0.5 mV. A: Anteroposterior projection; B: posteroanterior projection.
Heart Rhythm  , DOI: ( /j.hrthm )
Copyright © 2016 Heart Rhythm Society Terms and Conditions

5. Figure 4
Remapping in another patient from group 2 six months after the procedure with proven isolation. A: Voltage mapping at different projections (left: anteroposterior projection; right: posteroanterior projection) showed low voltage inside the pulmonary veins (PVs), on the left atrial posterior wall (LAPW), at the base of the left atrium, and on the left-sided interatrial septum. B: Intracardiac electrograms demonstrated isolation of 1 of the PVs (the circular catheter [Ls] was placed inside the left superior PV). Despite isolation of the PVs and LAPW, the patient had recurrent left atrial flutter, as shown in the tracing. Top to bottom: Surface ECG leads I, II, aVF, and V1; intracardiac electrogram of crista terminalis (CR 1–10), pulmonary vein (circular catheter, Ls 1–10), ablation catheter proximal (ABL) and distal (ABL d) site, and coronary sinus (CS 1–10).
Heart Rhythm  , DOI: ( /j.hrthm )
Copyright © 2016 Heart Rhythm Society Terms and Conditions

6. Figure 5
Flow chart of the study design and patient outcome in both groups. AAD = antiarrhythmia drug; AF = atrial fibrillation; AFL = atrial flutter; AT = atrial tachycardia; ePVAI+LAPW = pulmonary vein antral isolation extended to the coronary sinus and to the left side of the interatrial septum; LAPW = left atrial posterior wall; PerAF = persistent atrial fibrillation; PV = pulmonary vein; PVAI = pulmonary vein antral isolation; SVC = superior vena cava.
Heart Rhythm  , DOI: ( /j.hrthm )
Copyright © 2016 Heart Rhythm Society Terms and Conditions

7. Figure 6
Kaplan-Meier survival curves showing each group’s cumulative atrial tachyarrhythmia–free survival at 12-, 24-, and 36-month follow-up. LAPW = left atrial posterior wall; PVAI = pulmonary vein antral isolation.
Heart Rhythm  , DOI: ( /j.hrthm )
Copyright © 2016 Heart Rhythm Society Terms and Conditions