{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T05:29:53Z","timestamp":1792214993932,"version":"4.4.0"},"reference-count":32,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007311","name":"Cleveland Clinic Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007311","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","heartrhythmjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Heart Rhythm"],"published-print":{"date-parts":[[2025,11]]},"DOI":"10.1016\/j.hrthm.2025.05.010","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T02:06:03Z","timestamp":1747015563000},"page":"2938-2947","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"title":["Feasibility of unipolar signal\u2013guided ablation in creating contiguous lines of conduction block: A proof-of-concept study"],"prefix":"10.1016","volume":"22","author":[{"given":"Hagai D.","family":"Yavin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arwa","family":"Younis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arsalan","family":"Derakhshan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Koch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Krywanczyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayley","family":"Bryce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander Sean","family":"Esposito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liad","family":"Naveh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Kanj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakub","family":"Sroubek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oussama","family":"Wazni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Santangeli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3970-3267","authenticated-orcid":false,"given":"Christine","family":"Tanaka-Esposito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"suppl 22","key":"10.1016\/j.hrthm.2025.05.010_bib1","article-title":"Abstract 12104: prospective study using a new formula incorporating contact force, radiofrequency power and application time (force-power-time index) for quantifying lesion formation to g:uide long continuous atrial lesions in the beating canine heart","volume":"128","author":"Nakagawa","year":"2013","journal-title":"Circulation"},{"issue":"suppl","key":"10.1016\/j.hrthm.2025.05.010_bib2","article-title":"Prospective study to test the ability to create RF lesions at predicted depth and diameter using a new formula incorporating contact force, radiofrequency power and application time (force-power-time index) in the beating heart","volume":"11","author":"Nakagawa","year":"2014","journal-title":"Heart Rhythm"},{"key":"10.1016\/j.hrthm.2025.05.010_bib3","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.ipej.2019.05.001","article-title":"Ablation-index guided versus conventional contact-force guided ablation in pulmonary vein isolation- systematic review and meta-analysis","volume":"19","author":"Pranata","year":"2019","journal-title":"Indian Pacing Electrophysiol J"},{"key":"10.1016\/j.hrthm.2025.05.010_bib4","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1161\/CIRCEP.111.962720","article-title":"Left atrial anatomy revisited","volume":"5","author":"Ho","year":"2012","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib5","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1111\/j.1540-8167.2011.02100.x","article-title":"Left atrial wall thickness variability measured by CT scans in patients undergoing pulmonary vein isolation","volume":"22","author":"Beinart","year":"2011","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib6","first-page":"775","article-title":"Ablation index, a novel marker of ablation lesion quality: prediction of pulmonary vein reconnection at repeat electrophysiology study and regional differences in target values","volume":"19","author":"Das","year":"2017","journal-title":"Europace"},{"key":"10.1016\/j.hrthm.2025.05.010_bib7","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.118.006576","article-title":"Use of ablation index-guided ablation results in high rates of durable pulmonary vein isolation and freedom from arrhythmia in persistent atrial fibrillation patients: the PRAISE study results","volume":"11","author":"Hussein","year":"2018","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib8","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1093\/europace\/euaa157","article-title":"Standardized pulmonary vein isolation workflow to enclose veins with contiguous lesions: the multicentre VISTAX trial","volume":"22","author":"Duytschaever","year":"2020","journal-title":"Europace"},{"key":"10.1016\/j.hrthm.2025.05.010_bib9","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1016\/j.jacep.2022.06.007","article-title":"Composite index tagging for PVI in paroxysmal AF: a prospective, multicenter postapproval study","volume":"8","author":"Di Biase","year":"2022","journal-title":"JACC Clin Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib10","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euad221","article-title":"Acute and mid-term outcomes of ablation for atrial fibrillation with VISITAG SURPOINT: the Japan MIYABI registry","volume":"25","author":"Okumura","year":"2023","journal-title":"Europace"},{"key":"10.1016\/j.hrthm.2025.05.010_bib11","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1161\/01.RES.48.1.39","article-title":"The discontinuous nature of propagation in normal canine cardiac muscle. Evidence for recurrent discontinuities of intracellular resistance that affect the membrane currents","volume":"48","author":"Spach","year":"1981","journal-title":"Circ Res"},{"key":"10.1016\/j.hrthm.2025.05.010_bib12","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1161\/01.RES.29.5.499","article-title":"Collision of excitation waves in the dog Purkinje system. Extracellular identification","volume":"29","author":"Spach","year":"1971","journal-title":"Circ Res"},{"key":"10.1016\/j.hrthm.2025.05.010_bib13","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1016\/j.hrthm.2010.06.014","article-title":"Local unipolar and bipolar electrogram criteria for evaluating the transmurality of atrial ablation lesions at different catheter orientations relative to the endocardial surface","volume":"7","author":"Otomo","year":"2010","journal-title":"Heart Rhythm"},{"key":"10.1016\/j.hrthm.2025.05.010_bib14","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1161\/CIRCEP.115.002894","article-title":"Elimination of the negative component of the unipolar atrial electrogram as an in vivo marker of transmural lesion creation: acute study in canines","volume":"8","author":"Bortone","year":"2015","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib15","doi-asserted-by":"crossref","first-page":"2690","DOI":"10.19102\/icrm.2017.080407","article-title":"Initial experience with the BioSig PURE EPTM signal recording system: an animal laboratory experience","volume":"8","author":"Padmanabhan","year":"2017","journal-title":"J Innov Card Rhythm Manag"},{"key":"10.1016\/j.hrthm.2025.05.010_bib16","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.119.007304","article-title":"High-Power (40\u201350W) radiofrequency ablation guided by unipolar signal modification for pulmonary vein isolation: experimental findings and clinical results","volume":"12","author":"Pambrun","year":"2019","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib17","doi-asserted-by":"crossref","first-page":"f419","DOI":"10.1093\/europace\/eux376","article-title":"Improving procedural and one-year outcome after contact force-guided pulmonary vein isolation: the role of interlesion distance, ablation index, and contact force variability in the \u2018CLOSE\u2019-protocol","volume":"20","author":"Philips","year":"2018","journal-title":"Europace"},{"key":"10.1016\/j.hrthm.2025.05.010_bib18","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1161\/01.CIR.82.3.1034","article-title":"Observations on electrode-tissue interface temperature and effect on electrical impedance during radiofrequency ablation of ventricular myocardium","volume":"82","author":"Haines","year":"1990","journal-title":"Circulation"},{"key":"10.1016\/j.hrthm.2025.05.010_bib19","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1161\/CIRCEP.113.000749","article-title":"Unipolar signal modification as a guide for lesion creation during radiofrequency application in the left atrium: prospective study in humans in the setting of paroxysmal atrial fibrillation catheter ablation","volume":"6","author":"Bortone","year":"2013","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib20","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s10840-017-0264-4","article-title":"Elimination of the negative component of the unipolar electrogram as a local procedural endpoint during paroxysmal atrial fibrillation catheter ablation using contact-force sensing: the UNIFORCE study","volume":"49","author":"Bortone","year":"2017","journal-title":"J Interv Card Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib21","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s10840-018-0470-8","article-title":"Unipolar electrogram-guided radiofrequency catheter ablation in paroxysmal atrial fibrillation: electrogram patterns and outcomes","volume":"54","author":"Fu","year":"2019","journal-title":"J Interv Card Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib22","first-page":"229","article-title":"Unipolar electrogram-guided versus lesion size index-guided catheter ablation in patients with paroxysmal atrial fibrillation","volume":"9","author":"Fu","year":"2022","journal-title":"J Cardiovasc Dev Dis"},{"key":"10.1016\/j.hrthm.2025.05.010_bib23","article-title":"Comparison between contact force monitoring and unipolar signal modification as a guide for catheter ablation of atrial fibrillation: prospective multi-center randomized study","volume":"12","author":"Ejima","year":"2019","journal-title":"Cir Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib24","doi-asserted-by":"crossref","first-page":"1702","DOI":"10.1111\/jce.14532","article-title":"Comparison of high power and conventional-power radiofrequency energy deliveries in pulmonary vein isolation using unipolar signal modification as a local endpoint","volume":"31","author":"Ejima","year":"2020","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib25","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1111\/jce.12754","article-title":"Modification of the unipolar atrial electrogram as a local endpoint during common atrial flutter ablation","volume":"26","author":"Pambrun","year":"2015","journal-title":"J Cardiovasc Elecrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib26","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1111\/pace.14642","article-title":"Correlation of unipolar electrogram modification with ablation index during pulmonary vein isolation: a pilot study","volume":"46","author":"Paymard","year":"2023","journal-title":"Pacing Clin Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib27","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euad310","article-title":"Optimal interlesion distance for 90 and 50 watt radio-frequency applications with low ablation index values: experimental findings in a chronic ovine model","volume":"25","author":"Bortone","year":"2023","journal-title":"Europace"},{"key":"10.1016\/j.hrthm.2025.05.010_bib28","article-title":"Comparison of in vivo tissue temperature profile and lesion geometry for radiofrequency ablation with high power-short duration and moderate power-moderate duration: effects of thermal latency and contact force on lesion formation","volume":"14","author":"Nakagawa","year":"2021","journal-title":"Cir Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib29","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.jacep.2018.11.020","article-title":"Pulmonary vein reconnection no longer occurs in the majority of patients after a single pulmonary vein isolation procedure","volume":"5","author":"De Pooter","year":"2019","journal-title":"JACC Clin Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib30","doi-asserted-by":"crossref","first-page":"f401","DOI":"10.1093\/europace\/eux350","article-title":"Evaluation of left atrial linear ablation using contiguous and optimized radiofrequency lesions: the ALINE study","volume":"20","author":"Wolf","year":"2018","journal-title":"Europace"},{"key":"10.1016\/j.hrthm.2025.05.010_bib31","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/s10840-021-01110-y","article-title":"Impact of power and contact force on index-guided radiofrequency lesions in an ex vivo porcine heart model","volume":"63","author":"Lozano Granero","year":"2022","journal-title":"J Interv Card Electrophysiol"},{"key":"10.1016\/j.hrthm.2025.05.010_bib32","doi-asserted-by":"crossref","first-page":"2836","DOI":"10.1111\/jce.14709","article-title":"Impedance, power and current in radiofrequency ablation: insights from technical, ex vivo, and clinical studies","volume":"31","author":"Bourier","year":"2020","journal-title":"J Cardiovasc Electrophysiol"}],"container-title":["Heart Rhythm"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1547527125024336?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1547527125024336?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T18:02:55Z","timestamp":1778868175000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1547527125024336"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":32,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["S1547527125024336"],"URL":"https:\/\/doi.org\/10.1016\/j.hrthm.2025.05.010","relation":{},"ISSN":["1547-5271"],"issn-type":[{"value":"1547-5271","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Feasibility of unipolar signal\u2013guided ablation in creating contiguous lines of conduction block: A proof-of-concept study","name":"articletitle","label":"Article Title"},{"value":"Heart Rhythm","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.hrthm.2025.05.010","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Heart Rhythm Society.","name":"copyright","label":"Copyright"}]}}