{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:08:36Z","timestamp":1792465716780,"version":"4.5.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T00:00:00Z","timestamp":1669334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,16]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Pulsed-field ablation (PFA) can offer a novel perspective for atrial fibrillation (AF) ablation. We aimed to characterize the incidence of pulmonary vein (PV) reconnection, types of recurrent atrial tachyarrhythmia (ATa) and lesion quality after PFA-guided PV isolation (PVI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Patients undergoing second ablation for recurrent ATa following the initial PVI using the pentaspline PFA catheter were investigated. The rate of PV reconnection, the features of recurrent ATa, and the amount of isolated posterior wall (PW) surface area (ISAPW%) (ratio of the isolated- to total surface area on PW) were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 360 patients treated with PFA, 25 patients (paroxysmal AF, n = 19) with 99 PVs underwent a second procedure 6.1 \u00b1 4.0 months after the initial procedure. The rate of PV reconnection was 9.1% (9 PVs). Patients presented with atrial tachycardia (AT) (n = 16), AF (n = 8) and typical atrial flutter (n = 1). The mechanism of all but one AT was macro-reentry. The critical isthmus was found to be linked to the initial lesion set at the left atrial (LA) PW in eight patients and linked to pre-existing substrate at the LA anterior wall in four patients. One AT had a focal origin at the septum. In three patients, AT were unmappable. Mean ISAPW% was 72.7 \u00b1 19.0%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We revealed a remarkable low reconnection rate with a large antral lesion at the PW after pentaspline PFA catheter-guided PVI. However, macro-reentrant AT with a critical isthmus at the LAPW linked to the PVI lesion set was commonly observed.<\/jats:p><\/jats:sec>","DOI":"10.1093\/europace\/euac211","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T16:20:13Z","timestamp":1669393213000},"page":"433-440","source":"Crossref","is-referenced-by-count":100,"title":["Findings from repeat ablation using high-density mapping after pulmonary vein isolation with pulsed field ablation"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0299-362X","authenticated-orcid":false,"given":"Shota","family":"Tohoku","sequence":"first","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien , Wilhelm-Epstein Str. 4, 60431 Frankfurt , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2355-6015","authenticated-orcid":false,"given":"K R Julian","family":"Chun","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien , Wilhelm-Epstein Str. 4, 60431 Frankfurt , Germany"},{"name":"Die Sektion Medizin, Universit\u00e4t zu L\u00fcbeck , Ratzeburger Allee 160, 23562 L\u00fcbeck , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0282-4658","authenticated-orcid":false,"given":"Stefano","family":"Bordignon","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien , Wilhelm-Epstein Str. 4, 60431 Frankfurt , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaojie","family":"Chen","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien , Wilhelm-Epstein Str. 4, 60431 Frankfurt , Germany"},{"name":"Die Sektion Medizin, Universit\u00e4t zu L\u00fcbeck , Ratzeburger Allee 160, 23562 L\u00fcbeck , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4188-3447","authenticated-orcid":false,"given":"David","family":"Schaack","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien , Wilhelm-Epstein Str. 4, 60431 Frankfurt , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5234-744X","authenticated-orcid":false,"given":"Lukas","family":"Urbanek","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien , Wilhelm-Epstein Str. 4, 60431 Frankfurt , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramin","family":"Ebrahimi","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien , Wilhelm-Epstein Str. 4, 60431 Frankfurt , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5588-0533","authenticated-orcid":false,"given":"Jun","family":"Hirokami","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien , Wilhelm-Epstein Str. 4, 60431 Frankfurt , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7922-3244","authenticated-orcid":false,"given":"Fabrizio","family":"Bologna","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien , Wilhelm-Epstein Str. 4, 60431 Frankfurt , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5347-9906","authenticated-orcid":false,"given":"Boris","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien , Wilhelm-Epstein Str. 4, 60431 Frankfurt , Germany"},{"name":"Universit\u00e4tsklinikum Frankfurt , Medizinische 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