{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T09:17:08Z","timestamp":1772356628822,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T00:00:00Z","timestamp":1589500800000},"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":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Negative component abolition of the unipolar signal (unipolar signal modification [USM]) reflects the lesion transmurality. The purpose of this study was to compare the procedural safety and outcome between high\u2010power and conventional\u2010power atrial radiofrequency applications during a pulmonary vein isolation (PVI) using USM as a local endpoint.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>High\u2010power (50\u2009W) and conventional\u2010power (25\u201040\u2009W) applications were compared among 120 consecutive patients with paroxysmal atrial fibrillation who underwent a USM\u2010guided PVI. The first 60 patients were treated with conventional\u2010power (CP) group\u00a0and last 60 with high\u2010power (HP) group. The atrial radiofrequency applications lasted for 5 to 10\u2009seconds (CP group) or 3 to 5\u2009seconds (HP group) after the USM. All procedures were performed using 3D mapping systems with image integration and esophageal temperature monitoring. The baseline characteristics were similar between the two groups. The HP group had fewer acute PV reconnections (62% vs\u00a078%;\u00a0<jats:italic>P<\/jats:italic>\u2009=\u2009.046) and a reduced procedure time (119.3\u2009\u00b1\u200928.1 vs\u00a0140.1\u2009\u00b1\u200951.2\u2009minutes;\u00a0<jats:italic>P<\/jats:italic>\u2009=\u2009.04). Freedom from recurrence after a single ablation procedure without any antiarrhythmic drugs was higher in the HP group than CP group (88.3% vs\u00a073.3% at 12\u2010months after the procedure, log\u2010rank;\u00a0<jats:italic>P<\/jats:italic>\u2009=\u2009.0423). There were no major complications that required any intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The high\u2010power PVI guided by USM decreased the procedural time and may improve the procedural outcomes without compromising the safety.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14532","type":"journal-article","created":{"date-parts":[[2020,5,7]],"date-time":"2020-05-07T05:38:33Z","timestamp":1588829913000},"page":"1702-1708","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Comparison of high\u2010power and conventional\u2010power radiofrequency energy deliveries in pulmonary vein isolation using unipolar signal modification as a local endpoint"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3195-9666","authenticated-orcid":false,"given":"Koichiro","family":"Ejima","sequence":"first","affiliation":[{"name":"Department of Cardiology Tokyo Women's Medical University  Tokyo Japan"},{"name":"Clinical Research Division for Heart Rhythm Management 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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8839-0186","authenticated-orcid":false,"given":"Kyoichiro","family":"Yazaki","sequence":"additional","affiliation":[{"name":"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 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