| Sumario: | Background: Use of lesion metric indices is a proposed strategy to support pulmonary vein isolation procedures and these indices show good correlations with lesion sizes. The aim of this in silico study is to provide a detailed analysis of radiofrequency (RF) settings, including high‐power short‐duration (HPSD) settings, and resulting lesion metric indices. Methods and Results: A software program was designed which simulated virtual RF ablations. Lesion metric indices (Ablation index: AI, Lesion size index: LSI) were calculated based on underlying RF settings (contact force [CF], power, duration). In series of calculations, the applied settings were varied within defined ranges (CF: 1‐80 g, power: 1‐60 W, duration: 1‐60 seconds). Overall, n = 388 000 virtual ablations were calculated. The resulting lesion metric indices were compared with each other and analyzed in relation to respective RF settings. Increasing contact force from 1 to 10 g resulted in a 4.4‐fold LSI value, whilst increasing contact force from 10 to 20g resulted in a 1.5‐fold value (P <.01). When RF power was increased by 10 W, lesion metric indices increased between 1.3‐ and 1.6‐fold. A prolongation of RF duration by 10 seconds resulted in a 1.2‐to‐1.3‐fold increase of lesion metric indices. HPSD RF applications of 50 W, 11 to 13 seconds, and 60 W, 8 to 10 seconds resulted in equivalent lesion metric indices when compared with 30 W, 30 seconds conventional ablations. Conclusions: The findings support the clinical use of contact forces within a 10 to 20 g range. AI is more sensitive to RF duration, whereas LSI is more sensitive to contact force. HPSD RF settings can successfully be derived from lesion metric indices.
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