{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:09:20Z","timestamp":1792642160507,"version":"4.5.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>\n                      Reversible pulsed field ablation (PF\n                      <jats:sub>REV<\/jats:sub>\n                      ) can temporarily block cardiomyocyte conduction, potentially identifying critical target sites before creating definitive lesions. However, PF\n                      <jats:sub>REV<\/jats:sub>\n                      local capture might interfere with the tachycardia mechanism. The aim of the study was to characterize the responses of nontriggered PF\n                      <jats:sub>REV<\/jats:sub>\n                      pulses to serve as a novel clinical mapping tool in reentrant atrial flutter.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      PF\n                      <jats:sub>REV<\/jats:sub>\n                      pulses were delivered in and outside of the circuit using a 9-mm lattice-tip catheter in 30 reentrant atrial tachycardias in 26 patients. The presence of local capture and responses to PF\n                      <jats:sub>REV<\/jats:sub>\n                      pulses was characterized.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Out of 163 PF\n                      <jats:sub>REV<\/jats:sub>\n                      pulses analyzed, 56 (34.4%) showed atrial capture and propagation. Propagated versus Nonpropagated PF\n                      <jats:sub>REV<\/jats:sub>\n                      cohorts were compared. The coupling interval of propagated PF\n                      <jats:sub>REV<\/jats:sub>\n                      pulses was significantly longer (195.3\u00b169.2 msec versus 98.9\u00b177.2 msec;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). Globally, 4 responses were observed: tachycardia termination (11.0%), stable tachycardia cycle length (TCL) prolongation (9.8%), transient irregular TCL variations (3.1%), and no change in activation sequence and TCL (76.1%). Propagation was only associated with irregular TCL variations (8.9% versus 0%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.002). Tachycardia termination or TCL prolongation occurred only when PF\n                      <jats:sub>REV<\/jats:sub>\n                      was delivered in the reentry circuit (100% specificity). Termination occurred exclusively in the critical isthmus (100% specificity regardless of propagation), and stable TCL prolongation occurred in 93.8% and 6.2% of the cases in the isthmus and outer loop, respectively (100% specificity for nonpropagated and 83.3% specificity for propagated PF\n                      <jats:sub>REV<\/jats:sub>\n                      to localize the isthmus). Sensitivity of termination or stable TCL prolongation for identifying the critical isthmus was moderate (38.8%) and influenced by isthmus width (11.7\u00b11.7 mm versus 22.9\u00b12.1 mm;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). Reproducibility of PF\n                      <jats:sub>REV<\/jats:sub>\n                      pulses, determined by consecutive pulses delivered at the same site producing identical responses, was high (82.9%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      PF\n                      <jats:sub>REV<\/jats:sub>\n                      mapping is a novel, feasible, and reproducible tool for identifying critical sites in reentrant atrial tachycardia with narrow isthmuses that may be improved through optimized triggering and dose titration.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.125.014359","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T10:00:31Z","timestamp":1770026431000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["First Clinical Experience With Reversible Electroporation Mapping in Atrial Flutter"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6549-4994","authenticated-orcid":true,"given":"Mar\u00eda","family":"Cesp\u00f3n-Fern\u00e1ndez","sequence":"first","affiliation":[{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium (M.C.-F., K.N., L.P., J.S., D.G.D.R., A.A., I.O., G.B., E.S., I.E., A.P., G.V., P.B., G.-B.C., C.d.A., A.S.)."},{"name":"Cardiology Department of University Hospital Alvaro Cunqueiro and Cardiovascular Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Vigo, Spain (M.C.-F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0262-9932","authenticated-orcid":true,"given":"Kazutaka","family":"Nakasone","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium (M.C.-F., K.N., L.P., J.S., D.G.D.R., A.A., I.O., G.B., E.S., I.E., A.P., G.V., P.B., G.-B.C., C.d.A., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9769-1511","authenticated-orcid":true,"given":"Luigi","family":"Pannone","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium (M.C.-F., K.N., L.P., J.S., D.G.D.R., A.A., I.O., G.B., E.S., I.E., A.P., G.V., P.B., G.-B.C., C.d.A., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Sieira","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium (M.C.-F., K.N., L.P., J.S., D.G.D.R., A.A., I.O., G.B., E.S., I.E., A.P., G.V., P.B., G.-B.C., C.d.A., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3837-3462","authenticated-orcid":true,"given":"Domenico G.","family":"Della Rocca","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium (M.C.-F., K.N., L.P., J.S., D.G.D.R., A.A., I.O., G.B., E.S., I.E., A.P., G.V., P.B., G.-B.C., C.d.A., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9743-1661","authenticated-orcid":true,"given":"Alexandre","family":"Almorad","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium (M.C.-F., K.N., L.P., J.S., D.G.D.R., A.A., I.O., G.B., E.S., I.E., A.P., G.V., P.B., G.-B.C., C.d.A., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Overeinder","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium (M.C.-F., K.N., L.P., J.S., D.G.D.R., A.A., I.O., G.B., E.S., I.E., A.P., G.V., P.B., G.-B.C., C.d.A., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gezim","family":"Bala","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium (M.C.-F., K.N., L.P., J.S., D.G.D.R., A.A., I.O., G.B., E.S., I.E., A.P., G.V., P.B., G.-B.C., C.d.A., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwin","family":"Str\u00f6ker","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium (M.C.-F., K.N., L.P., J.S., D.G.D.R., A.A., I.O., G.B., E.S., I.E., A.P., G.V., P.B., G.-B.C., C.d.A., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2832-9556","authenticated-orcid":true,"given":"Ivan","family":"Eltsov","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium (M.C.-F., K.N., L.P., J.S., D.G.D.R., A.A., I.O., G.B., E.S., I.E., A.P., G.V., P.B., G.-B.C., C.d.A., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5948-963X","authenticated-orcid":true,"given":"Anna","family":"Padis\u00e1k","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology 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