{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:50:18Z","timestamp":1791949818211,"version":"4.3.4"},"reference-count":8,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Unlike most pulsed\u2010field ablation (PFA) systems, Affera (Medtronic) delivers unipolar energy between a lattice\u2010tip catheter and a cutaneous return patch, potentially generating a broader electric field. We hypothesized that this may attenuate voltage beyond ablated regions and tested this using spatially matched pre\u2010 and post\u2010ablation maps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>\n                      We retrospectively studied five consecutive patients undergoing primary atrial fibrillation ablation with the Affera system. Pre\u2010 and immediate post\u2010ablation voltage maps were generated using CARTO 3 and OCTARAY (Biosense Webster) with identical settings during right atrial pacing. Because Affera lacks point\u2010level 3D coordinates for spatial matching, coordinates (x, y, z) and bipolar voltages were extracted from CARTO 3. Pre\u2010 and post\u2010ablation points\u2014outside energy delivery sites, excluding the annulus and left atrial appendage\u2014were spatially matched using a 2\u2009mm mutual nearest\u2010neighbor criterion. This yielded 3772 pairs. Bipolar voltages were averaged by case. Mean bipolar voltage decreased in all cases from 1.01\u2009\u00b1\u20090.61 to 0.56\u2009\u00b1\u20090.29\u2009mV, representing a 40.2% reduction (95% CI, 24.6%\u201355.8%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.044). In a distance\u2010stratified analysis, residual bipolar voltage (post\/pre \u00d7 100) was lowest just beyond the ablated zone and increased progressively with distance from the nearest application tag center (16.5% at 10\u201315\u2009mm to 57.8% at 25\u201330\u2009mm; all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), becoming numerically comparable to baseline beyond approximately 30\u2009mm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Affera\u2010based unipolar ablation produced acute bipolar voltage attenuation that extended into non\u2010ablated myocardium adjacent to the lesion set but diminished with distance and was largely confined within approximately 30\u2009mm of the application sites.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70511","type":"journal-article","created":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T17:58:32Z","timestamp":1790531912000},"page":"2413-2416","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Left Atrial Voltage Attenuation Beyond Ablation Sites After Unipolar Pulsed\u2010Field Ablation for Atrial Fibrillation"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7054-9734","authenticated-orcid":false,"given":"Satoshi","family":"Osaki","sequence":"first","affiliation":[{"name":"Department of Cardiology National Hospital Organization Osaka National Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8389-549X","authenticated-orcid":false,"given":"Koichi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Hospital Organization Osaka National Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Mishima","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Hospital Organization Osaka National Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8884-0677","authenticated-orcid":false,"given":"Tatsuhisa","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Hospital Organization Osaka National Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Ohashi","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Hospital Organization Osaka National Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhiko","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Hospital Organization Osaka National Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8682-2643","authenticated-orcid":false,"given":"Kuniyasu","family":"Ikeoka","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Hospital Organization Osaka National Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8665-2820","authenticated-orcid":false,"given":"Haruya","family":"Yamane","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Hospital Organization Osaka National Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Hospital Organization Osaka National Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0514-106X","authenticated-orcid":false,"given":"Yasunori","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Hospital Organization Osaka National Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.04.021"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hroo.2021.10.004"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.120.008580"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03022-6"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euq417"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.121.010375"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.123.012255"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.123.012018"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70511","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.70511","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70511","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:42:34Z","timestamp":1791949354000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.70511"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,27]]},"references-count":8,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/jce.70511"],"URL":"https:\/\/doi.org\/10.1111\/jce.70511","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,27]]},"assertion":[{"value":"2026-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}