{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:02:58Z","timestamp":1791295378819,"version":"4.1.0"},"reference-count":14,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulsed field ablation (PFA) is a nonthermal modality for pulmonary vein isolation in atrial fibrillation. Whether baseline intracardiac electrogram characteristics are associated with acute electrogram attenuation during PFA remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the individual and combined associations of baseline bipolar amplitude and peak frequency (PF) with acute electrogram attenuation during pulmonary vein PFA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty\u2010four consecutive patients undergoing pulmonary vein PFA were retrospectively analyzed. Paired bipolar electrograms were recorded immediately before and after the first PFA application from the same electrode pair and catheter position. Logistic regression, receiver operating characteristic (ROC) analysis, and nonlinear Hill modeling were performed. Additional analyses accounted for within\u2010patient clustering and evaluated alternative attenuation thresholds, pulmonary vein regional heterogeneity, and dynamic\u2212range constraints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 687 electrograms analyzed, marked attenuation (\u2265\u200980%) occurred in 59.1%. Both baseline amplitude and PF were significantly associated with marked attenuation. ROC analysis demonstrated strong discrimination for amplitude (AUC 0.894) and moderate discrimination for PF (AUC 0.722), with ROC\u2010derived cutoffs of 0.58\u2009mV and 206\u2009Hz, respectively. Both parameters remained independently associated with attenuation in multivariable analysis. Nonlinear modeling demonstrated distinct response patterns, with amplitude showing a gradual, broad dynamic\u2212range relationship and PF exhibiting a steeper, threshold\u2010like transition. Integration of amplitude and PF enabled graded stratification of attenuation across combined electrogram domains. These associations were preserved after accounting for within\u2010patient clustering and were directionally consistent across alternative attenuation thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Baseline bipolar amplitude and PF were independently associated with acute electrogram attenuation during pulmonary vein PFA. Their integration provides complementary, non\u2010redundant information and supports a structured electrogram\u2010based framework for interpreting acute electrogram response. These findings are hypothesis\u2010generating and require validation against durable pulmonary vein isolation, late reconnection, and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70513","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:41:59Z","timestamp":1791294119000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Electrogram Determinants of Acute Electrogram Attenuation During Pulmonary Vein Pulsed Field Ablation"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6974-9496","authenticated-orcid":false,"given":"Ryuichi","family":"Usui","sequence":"first","affiliation":[{"name":"Department of Cardiology Tokyo Heart Rhythm Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0359-4601","authenticated-orcid":false,"given":"Akihiko","family":"Nogami","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Heart Rhythm Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9113-5987","authenticated-orcid":false,"given":"Yuka","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Heart Rhythm Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kikuya","family":"Uno","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Heart Rhythm Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.124.012814"},{"key":"e_1_2_15_3_1","first-page":"e678","article-title":"Magnetic Resonance Imaging Analysis of Left Atrial Scar Formation Following Atrial Fibrillation Ablation Using a Novel Variable Loop Catheter for Pulsed Field Ablation","volume":"22","author":"Fink T.","year":"2025","journal-title":"Heart Rhythm: The Official Journal of the Heart Rhythm Society"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.70187"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-024-01967-9"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrcr.2025.06.032"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12774"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hroo.2024.11.025"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hroo.2026.01.019"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.15420\/aer.2020.24"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.113.978320"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.113.001094"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eut430"},{"key":"e_1_2_15_14_1","first-page":"1526","article-title":"In Vivo Contact Force Measurements and Correlation With Left Atrial Anatomy During Catheter Ablation of Atrial Fibrillation","volume":"17","author":"Schluermann F.","year":"2015","journal-title":"Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology: Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.114.002483"}],"container-title":["Journal of Cardiovascular 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