{
  "abstract": "Left atrial posterior wall (LAPW) narrowing after excessive extension of bilateral pulmonary vein isolation (PVI) lines during pulsed field ablation (PFA) may create a proarrhythmic substrate. The CARTO 3-integrated variable-loop circular catheter (VLCC) provides real-time tissue proximity indication (TPI) and ablation-tag location, but their relationship with LAPW narrowing remains unclear. Therefore, we evaluated associations of TPI status and inter-tag distance (ITD) with acute LAPW narrowing and whether an ITD-guided workflow was associated with LAPW preservation. Fifty-two retrospective and 27 prospective atrial fibrillation patients underwent PFA using a VLCC. In the retrospective phase, we evaluated the association between ITD, measured using TPI-positive tags and all tags, and LAPW narrowing (< 10 mm) and derived a cutoff. In the prospective phase, the ITD-guided workflow was applied, and we assessed residual LAPW band width. In the retrospective phase, both TPI-positive-tag ITD and all-tag ITD correlated with LAPW band width (r = 0.63 and 0.70, respectively; both p < 0.001). All-tag ITD showed a numerically higher AUC for LAPW narrowing than TPI-positive-tag ITD (0.869 vs. 0.795; p = 0.099), with an optimal all-tag ITD cutoff of 16.5 mm. In the prospective phase incorporating the all-tag ITD cutoff, residual LAPW band widths were wider at the roof (19.4 ± 7.9 vs. 25.1 ± 7.1 mm; p = 0.002) and carina (13.6 ± 7.1 vs. 20.8 ± 8.0 mm; p < 0.001) than in the retrospective phase. An all-tag ITD-guided workflow was associated with greater preservation of the residual LAPW band width.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Cardiology, Department of Medicine Nihon University School of Medicine Tokyo Japan."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yuji Saito",
      "orcid": "0009-0008-3916-4033"
    },
    {
      "affs": [
        0
      ],
      "name": "Koichi Nagashima",
      "orcid": "0000-0003-2326-225X"
    },
    {
      "affs": [
        0
      ],
      "name": "Ryuta Watanabe",
      "orcid": "0000-0003-2664-7139"
    },
    {
      "affs": [
        0
      ],
      "name": "Naoto Otsuka",
      "orcid": "0000-0002-6931-8522"
    },
    {
      "affs": [
        0
      ],
      "name": "Shu Hirata",
      "orcid": "0000-0003-0226-466X"
    },
    {
      "affs": [
        0
      ],
      "name": "Moyuru Hirata",
      "orcid": "0000-0003-2701-486X"
    },
    {
      "affs": [
        0
      ],
      "name": "Masanaru Sawada",
      "orcid": "0000-0002-9663-7617"
    },
    {
      "affs": [
        0
      ],
      "name": "Hikaru Masuda",
      "orcid": "0009-0008-3390-0837"
    },
    {
      "affs": [
        0
      ],
      "name": "Akinori Matsushima",
      "orcid": "0009-0001-6248-0463"
    },
    {
      "affs": [
        0
      ],
      "name": "Masato Sakaki"
    },
    {
      "affs": [
        0
      ],
      "name": "Yasuo Okumura",
      "orcid": "0000-0002-2960-4241"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dyfkwv50kq11e.bib",
  "cited_by": 0,
  "doi": "10.1002/joa3.70509",
  "fulltext_url": "https://europepmc.org/articles/PMC13715061",
  "id": "dyfkwv50kq11e",
  "issns": [
    "1880-4276",
    "1883-2148"
  ],
  "landing_url": "https://europepmc.org/article/MED/42953657",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2705|Atrial Fibrillation Management and Outcomes"
    ]
  ],
  "openalex": "W7224116956",
  "pdf_url": "https://europepmc.org/articles/PMC13715061?pdf=render",
  "pmcid": "PMC13715061",
  "pmid": "42953657",
  "published": "2026-10-28",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/dyfkwv50kq11e.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:40Z",
      "native_id": "MED:42953657",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42953657"
    },
    {
      "first_seen": "2026-11-01T12:22:26Z",
      "native_id": "PMC13715061",
      "source": "pmc",
      "url": "https://doi.org/10.1002/joa3.70509"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Atrial Fibrillation Management and Outcomes",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Posterior Pulmonary Vein Isolation Lesion Spacing and Left Atrial Posterior Wall Narrowing During Pulsed Field Ablation.",
  "title_text": "Posterior Pulmonary Vein Isolation Lesion Spacing and Left Atrial Posterior Wall Narrowing During Pulsed Field Ablation.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:22:26Z",
  "url": "https://research.draconitic.com/paper/dyfkwv50kq11e",
  "venue": "Journal of arrhythmia",
  "versions": []
}