{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T12:16:57Z","timestamp":1753273017974,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T00:00:00Z","timestamp":1626998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute pulmonary vein reconnection (PVR) is associated with long procedure times and large radiofrequency (RF) energy delivery during pulmonary vein isolation (PVI). Although the efficacy of high\u2010power PVI (HP\u2010PVI) has been recently established, the determinants of acute PVR following HP\u2010PVI remain unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated data on 62 patients with paroxysmal atrial fibrillation undergoing unipolar signal modification (USM)\u2010guided HP\u2010PVI. A 50\u2010W RF wave was applied for 3\u20105\u00a0seconds after USM. In the segments adjacent to the esophagus (SAEs), the RF time was limited to 5\u00a0seconds. Each circle was subdivided into six regions (segments), and the possible predictors of acute PVR, including minimum contact force (CF<jats:sub>min<\/jats:sub>), minimum force\u2010time integral (FTI<jats:sub>min<\/jats:sub>), minimum ablation index (AI<jats:sub>min<\/jats:sub>), minimum impedance drop (Imp\u2010min), and maximum inter\u2010lesion distance (ILD<jats:sub>max<\/jats:sub>), were assessed in each segment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We investigated 1162 ablations in 744 segments (including 124 SAEs). Acute PVR was observed in 21 (17%) SAEs and 43 (7%) other segments (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001). The acute PVR segments were characterized by significantly lower CF<jats:sub>min<\/jats:sub>, FTI<jats:sub>min<\/jats:sub>, AI<jats:sub>min<\/jats:sub>, and Imp\u2010min values in the segments other than the SAEs and larger ILD<jats:sub>max<\/jats:sub> values in the SAEs. Furthermore, lower Imp\u2010min and larger ILD<jats:sub>max<\/jats:sub> values independently predicted acute PVR in the segments other than the SAEs and SAEs (odds ratios 0.90 and 1.39 respectively). Acute PVR was not significantly associated with late atrial fibrillation recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Avoiding PVR remains a challenge in HP\u2010PVI cases, but it might be resolved by setting the optimal target impedance drop and lesion distance values.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.12597","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T09:46:09Z","timestamp":1627033569000},"page":"1260-1269","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Regional differences in the predictors of acute electrical reconnection following high\u2010power pulmonary vein isolation for paroxysmal atrial fibrillation"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8839-0186","authenticated-orcid":false,"given":"Kyoichiro","family":"Yazaki","sequence":"first","affiliation":[{"name":"Department of Cardiology Tokyo Women's Medical University Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3195-9666","authenticated-orcid":false,"given":"Koichiro","family":"Ejima","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Women's Medical University Tokyo Japan"},{"name":"Clinical Research Division for Heart Rhythm Management Department of Cardiology Tokyo Women's Medical University Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shohei","family":"Kataoka","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Women's Medical University Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miwa","family":"Kanai","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Women's Medical University Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1644-3140","authenticated-orcid":false,"given":"Satoshi","family":"Higuchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Women's Medical University Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daigo","family":"Yagishita","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Women's Medical University Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1772-6823","authenticated-orcid":false,"given":"Morio","family":"Shoda","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Women's Medical University Tokyo Japan"},{"name":"Clinical Research Division for Heart Rhythm Management Department of Cardiology Tokyo Women's Medical University Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhisa","family":"Hagiwara","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Women's Medical University Tokyo 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seconds of 50\u201360 W radio frequency atrial ablations were transmural and safe: an in vitro mechanistic assessment and force\u2010controlled in vivo validation","volume":"19","author":"Bhaskaran 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