{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:04:33Z","timestamp":1788498273081,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"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":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The variable loop circular catheter (VLCC) called VARIPULSE is a novel device designed for catheter ablation of atrial fibrillation (AFib) and electro\u2010anatomical mapping via 3D intracardiac echocardiography (ICE). Described herein is a streamlined workflow for AFib ablation and reported feasibility, procedural efficiency, and early safety signals of the first 34 consecutive patients. The technical details of step\u2010by\u2010step techniques are described to serve as a practical guide for clinicians and investigators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective, single\u2010center review of procedural parameters was done on 34 paroxysmal and\/or persistent AFib patients who were treated with a VLCC for both mapping and ablating between January 1, 2025 and May 15, 2025. The workflow of all procedures was comprised of general anesthesia administration, placement of 2 sheaths via ultrasound guided access, administration of a heparin bolus, 3D anatomical mapping of the pulmonary veins with CARTOSOUND FAM, a transeptal puncture, VLCC ablation, and then closure. Figures illustrating key procedural steps, including catheter maneuvering, are included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All 34 cases were done without fluoroscopy, with a median procedural time of 40.5 [IQR 19] min. After 10 procedures per operator, consistently shorter procedure times (&lt;45min) were achieved. No major acute or 30\u2010day complications were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This review of the initial 34 patients undergoing ICE and cardiac ablation using the VLCC catheter, exhibits a fluoroless, streamlined workflow that is feasible and operationally efficient, with early safety signals that require validation in larger, prospective studies. Notably, this approach did not require multiple transvenous access sites, pre\u2010procedural cross\u2010sectional imaging, right atrial matrix, or additional multielectrode catheters that would necessitate frequent catheter\u2010cable switching.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70244","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T17:03:47Z","timestamp":1775667827000},"page":"1047-1057","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["How to Use a Variable Loop Circular Catheter to Perform Zero Fluoro Pulmonary Vein Isolation With Pulsed Field Ablation"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6748-0713","authenticated-orcid":false,"given":"William K.","family":"Chan","sequence":"first","affiliation":[{"name":"Heart Rhythm Program Waterloo Regional Health Network  Kitchener Ontario Canada"},{"name":"Department of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melani","family":"Keshishi","sequence":"additional","affiliation":[{"name":"Department of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Gomez","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson, MedTech, 31 Technology Dr Suite  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umjeet S.","family":"Jolly","sequence":"additional","affiliation":[{"name":"Heart Rhythm Program Waterloo Regional Health Network  Kitchener Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.122.011780"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytaf107"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.13174"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-025-01981-5"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ipej.2016.10.011"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euad211"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.16366"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.23936"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.15177"},{"key":"e_1_2_9_11_1","article-title":"In Vivo Assessment of Catheter\u2010Tissue Contact Using Tissue Proximity Indication and Its Impact on Cardiac Lesion Formation in Pulsed Field Ablation","author":"Okumura Y.","year":"2024","journal-title":"Heart Rhythm"},{"issue":"9","key":"e_1_2_9_12_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"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2025.01.022"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytaf231"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2025.05.045"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euaf012"},{"key":"e_1_2_9_17_1","unstructured":"F.Bessi\u00e8re M. B.Kronborg P.Sommer et\u00a0al. \u201cEvaluating Safety Profile and Learning Curve With a Pulsed Field Ablation Variable Loop Circular Catheter in Procedures for AF: Observations From a Prospective Multicenter Postmarket Clinical Trial \u201d."},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euac050"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2025.03.1161"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.70439"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2025.04.018"}],"container-title":["Pacing and Clinical Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.70244","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pace.70244","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.70244","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:27:24Z","timestamp":1786386444000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pace.70244"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,8]]},"references-count":20,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/pace.70244"],"URL":"https:\/\/doi.org\/10.1111\/pace.70244","archive":["Portico"],"relation":{},"ISSN":["0147-8389","1540-8159"],"issn-type":[{"value":"0147-8389","type":"print"},{"value":"1540-8159","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,8]]},"assertion":[{"value":"2025-10-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}