{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T14:30:52Z","timestamp":1793802652395,"version":"4.6.1"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>\n                      The variable loop circular catheter has been shown to be a safe, effective pulsed field ablation catheter for atrial fibrillation treatment. After the commercial launch of the initial waveform (Seq1), a new waveform (Seq2\n                      <jats:sub>30 mL\/min<\/jats:sub>\n                      ) was developed that reduces electrode surface temperature and ablation delivery time (20\u20133.8 seconds). This study compares the safety and efficacy of Seq1 versus Seq2 across 2 irrigation rates and 2 dosing conditions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      Twenty-four Yorkshire pigs were treated with pulsed field ablation using the variable loop circular catheter. Subjects were randomized into 3 pulse recipe\/irrigation arms (Seq1\n                      <jats:sub>4 mL\/min<\/jats:sub>\n                      , Seq1\n                      <jats:sub>30 mL\/min<\/jats:sub>\n                      , and Seq 2\n                      <jats:sub>30<\/jats:sub>\n                      <jats:sub>mL\/min<\/jats:sub>\n                      ). Each group was split into a 1\u00d7 nominal and a 2\u00d7-dose group, resulting in 6 total study groups. Animals were monitored for 28\u00b12 days postablation for follow-up remapping procedures before euthanization. Gross necropsy and histopathology were performed on day 28\u00b12.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      In all groups, 100% acute and chronic pulmonary vein isolation effectiveness was observed, as indicated by transmural, circumferential, pulmonary vein lesions with no evidence of collateral injury. Transmurality in the left atrial appendage, LA roof, and posterior wall was 75% to 100% across all groups and absent at the mitral isthmus. No catheter thrombus\/char was observed at Seq2\n                      <jats:sub>30 mL\/min<\/jats:sub>\n                      or Seq1\n                      <jats:sub>30 mL\/min<\/jats:sub>\n                      . With Seq1\n                      <jats:sub>4 mL\/min<\/jats:sub>\n                      , thrombus\/char occurred in 25% (1\u00d7) and 100% (2\u00d7). Hemolysis and myocardial injury marker changes were similar between all groups, with a notable increase in the 2\u00d7 groups. On echocardiography, Seq2\n                      <jats:sub>30 mL\/min<\/jats:sub>\n                      microbubbles were rated as few or none, while Seq1\n                      <jats:sub>4 mL\/min<\/jats:sub>\n                      and Seq1\n                      <jats:sub>30 mL\/min<\/jats:sub>\n                      were mostly rated moderate or shower.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      Consistently durable pulmonary vein isolation was observed across all groups, including Seq1\n                      <jats:sub>4 mL\/min<\/jats:sub>\n                      , Seq2\n                      <jats:sub>30 mL\/min<\/jats:sub>\n                      , and Seq1\n                      <jats:sub>30 mL\/min<\/jats:sub>\n                      across both dosing conditions. Seq2\n                      <jats:sub>30 mL\/min<\/jats:sub>\n                      was associated with a reduced ablation delivery time (3.8 seconds), zero catheter thrombus formation, and few microbubbles. Higher irrigation flow in Seq1\n                      <jats:sub>30 mL\/min<\/jats:sub>\n                      also mitigated catheter thrombus formation but did not reduce microbubble generation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.126.015042","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T09:01:00Z","timestamp":1790154060000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Pulsed Field Timing Sequence and Electrode Cooling on Ablation Safety and Efficacy Surrogates: A Preclinical Study"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6508-4047","authenticated-orcid":true,"given":"Luigi","family":"Di Biase","sequence":"first","affiliation":[{"name":"Department of Cardiology, Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Bronx, NY (L.D.B., F.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1523-573X","authenticated-orcid":true,"given":"Jonathan","family":"Hsu","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Diego (J.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7734-8660","authenticated-orcid":true,"given":"Rahul","family":"Bhardwaj","sequence":"additional","affiliation":[{"name":"Departments of Cardiology and Electrophysiology, Loma Linda University Medical Center, Loma Linda University International Heart Institute, CA (R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Newton","sequence":"additional","affiliation":[{"name":"Clinical Cardiac Electrophysiology Department, Memorial Health University Medical Center, Savannah, GA (D.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5529-3221","authenticated-orcid":true,"given":"William","family":"Maddox","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham (W.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6420-8669","authenticated-orcid":true,"given":"Jorge E.","family":"Romero","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, Upstate Medical University, Syracuse, NY (J.E.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8885-1891","authenticated-orcid":true,"given":"Tara","family":"Gomez","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson MedTech, Irvine, CA (T.G., E.B., Q.C., C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9389-2369","authenticated-orcid":true,"given":"Eric","family":"Byun","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson MedTech, Irvine, CA (T.G., E.B., Q.C., C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Chen","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson MedTech, Irvine, CA (T.G., E.B., Q.C., C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Beeckler","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson MedTech, Irvine, CA (T.G., E.B., Q.C., C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6355-8843","authenticated-orcid":true,"given":"Fengwei","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Bronx, NY (L.D.B., F.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8556-3612","authenticated-orcid":true,"given":"William H.","family":"Sauer","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Service, Brigham and Women\u2019s Hospital, Boston, MA (W.H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae176"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euaf326"},{"key":"e_1_3_3_4_2","unstructured":"Johnson & Johnson MedTech receives FDA approval for the VARIPULSETM pulsed field ablation platform for the treatment of atrial fibrillation. Johnson & Johnson Biosense Webster Inc. Published November 7 2024. Accesed January 1 2026. JNJ.comhttps:\/\/www.jnj.com\/media-center\/press-releases\/johnson-johnson-medtech-receives-fda-approval-for-the-varipulse-pulsed-field-ablation-platform-for-the-treatment-of-atrial-fibrillation"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2025.04.018"},{"key":"e_1_3_3_6_2","unstructured":"Johnson & Johnson Receives FDA Approval for Updated VARIPULSETM Platform Irrigation Rate. Johnson & Johnson Biosense Webster Inc. Published November 7 2024. Accesed January 1 2026. 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