{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:46:28Z","timestamp":1791740788466,"version":"4.3.4"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"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>Introduction<\/jats:title>\n                    <jats:p>There is no bipolar\u2010specific quantitative ablation index currently available to guide pulsed field ablation (PFA). We aimed to develop and validate a novel contact force (CF)\u2010integrated pulsed field quantization index (PFQI) for real\u2010time lesion depth prediction during bipolar PFA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>\n                      In total, 27 healthy Yorkshire swine were included in a two\u2010phase preclinical study. In Phase I, a nonlinear multivariable model was developed to derive a novel PFQI incorporating real\u2010time CF, pulse train number, delivery voltage, and impedance variation. In Phase II, the PFQI was prospectively validated by comparing predicted with actual lesion depth, followed by PFQI\u2010guided circumferential pulmonary vein isolation (PVI). Acute procedural success, 30\u2010day PVI durability, and extracardiac safety were evaluated using serial electroanatomic mapping and blinded histopathological examination. Lesion depth was strongly associated with CF, pulse train number, voltage, and impedance change. The PFQI predicted actual depth with high accuracy (\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u20090.94,\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.88; validation\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.82, slope\u2009=\u20091.014). In the validation cohort, 92% of predicted depths fell within \u00b10.75\u2009mm of measured values. PFQI\u2010guided PVI achieved 100% (6\/6) acute isolation and 100% 30\u2010day durable electrical isolation, with contiguous transmural fibrosis on histology. No collateral phrenic nerve, esophageal, or pulmonary vein injury occurred, and phrenic capture thresholds remained unchanged.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The PFQI is the first bipolar\u2010specific, CF\u2010integrated quantitative metric for PFA, enabling accurate, real\u2010time lesion depth prediction. PFQI\u2010guided PVI achieved consistent, durable, and safe PVI in a porcine model, providing a promising operator\u2010independent quantitative strategy to optimize clinical bipolar PFA for atrial fibrillation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70527","type":"journal-article","created":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:06:25Z","timestamp":1791738385000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Validation of a Novel Contact Force\u2010Integrated Pulsed Field Quantization Index for Pulmonary Vein Isolation in a Porcine Model"],"prefix":"10.1111","author":[{"given":"Jie","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyue","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Research and Development APT Medical Inc Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanbin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changsong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiucan","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenzu","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengjia","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huishan","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Research and Development APT Medical Inc Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanbo","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuo","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Research and Development APT Medical Inc Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0253-6840","authenticated-orcid":false,"given":"Hu","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1161\/CIRCULATIONAHA.123.063988","article-title":"Pulsed Field Ablation for the Treatment of Atrial Fibrillation: PULSED AF Pivotal Trial","volume":"147","author":"Verma A.","year":"2023","journal-title":"Circulation"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1111\/jce.14980","article-title":"Safety and Chronic Lesion Characterization of Pulsed Field Ablation in a Porcine Model","volume":"32","author":"Stewart M. T.","year":"2021","journal-title":"Journal of Cardiovascular Electrophysiology"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.jacc.2019.04.021","article-title":"Pulsed Field Ablation for Pulmonary Vein Isolation in Atrial Fibrillation","volume":"74","author":"Reddy V. Y.","year":"2019","journal-title":"Journal of the American College of Cardiology"},{"key":"e_1_2_10_5_1","article-title":"Evaluation of Ablation Parameters to Predict Irreversible Lesion Size During Pulsed Field Ablation","volume":"17","author":"Nakagawa H.","year":"2024","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","DOI":"10.1002\/clc.24220","article-title":"A Novel Contact Force Sensing Pulsed Field Ablation Catheter in a Porcine Model","volume":"47","author":"Hua J.","year":"2024","journal-title":"Clinical Cardiology"},{"key":"e_1_2_10_7_1","first-page":"1174","article-title":"Relationship Between Catheter Contact Force and Radiofrequency Lesion Size and Incidence of Steam Pop in the Beating Canine Heart","volume":"7","author":"Ikeda A.","year":"2014","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"key":"e_1_2_10_8_1","article-title":"Effect of Sequential, Colocalized Radiofrequency and Pulsed Field Ablation on Cardiac Lesion Size and Histology","volume":"18","author":"Verma A.","year":"2025","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2024.1426920","article-title":"Preclinical Evaluation of Reversible Pulsed Electrical Field: Electrophysiological and Histological Assessment of Myocardium","volume":"11","author":"Zhai Z.","year":"2024","journal-title":"Frontiers in Cardiovascular Medicine"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.tcm.2021.07.006","article-title":"Pulsed Field Catheter Ablation in Atrial Fibrillation","volume":"32","author":"Di Biase L.","year":"2022","journal-title":"Trends in Cardiovascular Medicine"},{"key":"e_1_2_10_11_1","volume-title":"Guide for the Care and Use of Laboratory Animals","author":"National Research Council (US)","year":"2011"},{"key":"e_1_2_10_12_1","article-title":"Preclinical Evaluation of Pulsed Field Ablation: Electrophysiological and Histological Assessment of Thoracic Vein Isolation","volume":"12","author":"Koruth J.","year":"2019","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"key":"e_1_2_10_13_1","first-page":"121","article-title":"Feasibility and Safety of a Novel Contact Force\u2010Sensing Pulsed Field Ablation Catheter for Atrial Arrhythmias","volume":"35","author":"Huang Q.","year":"2024","journal-title":"Journal of Cardiovascular Electrophysiology"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"2136","DOI":"10.1111\/jce.14414","article-title":"Pulsed Field Ablation for Pulmonary Vein Isolation in the Treatment of Atrial Fibrillation","volume":"31","author":"Bradley C. J.","year":"2020","journal-title":"Journal of Cardiovascular Electrophysiology"},{"key":"e_1_2_10_15_1","article-title":"Paroxysmal Atrial Fibrillation Ablation Using a Novel Variable\u2010Loop Biphasic Pulsed Field Ablation Catheter Integrated With a 3\u2010Dimensional Mapping System: 1\u2010Year Outcomes of the Multicenter InspIRE Study","volume":"16","author":"Duytschaever M.","year":"2023","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"key":"e_1_2_10_16_1","article-title":"Characterization of Phrenic Nerve Response to Pulsed Field Ablation","volume":"15","author":"Howard B.","year":"2022","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"key":"e_1_2_10_17_1","article-title":"Effects of Contact Force on Lesion Size During Pulsed Field Catheter Ablation: Histochemical Characterization of Ventricular Lesion Boundaries","volume":"17","author":"Nakagawa H.","year":"2024","journal-title":"Circulation: Arrhythmia and Electrophysiology"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70527","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.70527","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70527","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:06:28Z","timestamp":1791738388000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.70527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,11]]},"references-count":16,"alternative-id":["10.1111\/jce.70527"],"URL":"https:\/\/doi.org\/10.1111\/jce.70527","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,11]]},"assertion":[{"value":"2026-07-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jce.70527"}}