{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T14:24:04Z","timestamp":1778077444950,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Electrophysiological characteristics of epicardial connections (ECs) in atria and pulmonary veins (PVs) are unclear despite their important contributions to atrial fibrillation (AF). Unidirectional conduction associated with source\u2010sink mismatch can occur in ECs due to their fine fibers with abrupt changes in orientation. We detailed the prevalence and electrophysiological characteristics of unidirectional conduction in the atria and investigated its association with the clinical manifestation of AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study retrospectively reviewed electrophysiological studies and radiofrequency catheter ablation in 261 consecutive patients with AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Unidirectional conduction was observed during ablation encircling the PVs in eight (3.1%) patients, and all occurred in the suspected (<jats:italic>N<\/jats:italic>\u2009=\u20094) or definitively (<jats:italic>N<\/jats:italic>\u2009=\u20094) recognized ECs. These ECs included three intercaval bundles, four septopulmonary bundles, and one Marshall bundle, and were first manifested in a second procedure in 6 (75%) patients. The unidirectional property was from PV to atrium (exit conduction) in all intercaval bundles and three septopulmonary bundles, and from atrium to PV (entrance conduction) in the remaining two bundles. Intercaval bundles acted as a limb of bi\u2010atrial macro\u2010reentrant tachycardia (50%, three of the six including previous cases). Ablation of the exit outside the PVs, including the right atrium, eliminated ECs in three (38%) patients. All patients remain free from arrhythmia recurrence after a mean 13\u2010month follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A unidirectional conduction property was closely associated with the EC, as estimated by histological findings. Recognition of this fact by electrophysiologists may help to clarify mechanisms for AF and atrial tachycardia and guide the creation of efficient and safe ablation lesion sets.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16065","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T08:50:35Z","timestamp":1694767835000},"page":"2262-2272","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Unidirectional conduction characterizing epicardial connections in patients with atrial tachyarrhythmias"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6033-2053","authenticated-orcid":false,"given":"Kentaro","family":"Yoshida","sequence":"first","affiliation":[{"name":"Department of Cardiology Institute of Medicine, University of Tsukuba Tsukuba Japan"},{"name":"Department of Cardiology Ibaraki Prefectural Central Hospital Kasama 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of Cardiology Institute of Medicine, University of Tsukuba Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masako","family":"Baba","sequence":"additional","affiliation":[{"name":"Department of Cardiology Institute of Medicine, University of Tsukuba Tsukuba Japan"},{"name":"Department of Cardiology Ibaraki Prefectural Central Hospital Kasama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiko","family":"Nogami","sequence":"additional","affiliation":[{"name":"Department of Cardiology Institute of Medicine, University of Tsukuba Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriyuki","family":"Takeyasu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ibaraki Prefectural Central Hospital Kasama 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