Arrhythmias & electrophysiologyResearch article
Unipolar voltage mapping to predict lesion durability during pulsed field ablation
- Patients undergoing pulsed field ablation (PFA) using a pentaspline catheter were enrolled
Authors' conclusion
A unipolar voltage ≤0.4 mV and loss of the terminal S wave on the u-EGM identify regions of durable ablation. Unipolar mapping may provide critical insights into durability and guide more effective PFA.
Study context
- Population
- Patients undergoing PFA using a pentaspline cathetergroup 1 10 · group 2 41 · group 3 69 · group 4 21
- Participants
- 10 / 41 / 69 / 21
- Comparison
- Double applications vs single applications
- group 1n = 10
- group 2n = 41
- group 3n = 69
- group 4n = 21
Main finding
As reported in the abstract
S-wave loss
Unipolar voltage ≤0.4 mV optimally predicted S-wave loss
≤0.4 mV
Further findings
Lesion size · larger and more durable lesions with double applications
P = 0.0075
Temporal stability of core and halo regions
- halo regions demonstrated recovery
- >1.08 mV unipolar, >0.5 mV bipolar
- Core lesions defined by this threshold remained temporally stable
Esophageal S-wave re-emergence
- Esophageal S-wave re-emergence occurred in single but not double applications, suggesting reversible electroporation
Conduction recovery in redo procedures
- a unipolar voltage ≥0.4 mV independently predicted areas of conduction recovery
- ≥0.4 mV
Original publication
Unipolar voltage mapping to predict lesion durability during pulsed field ablation. Heart Rhythm. Published 23 January 2026. doi:10.1016/j.hrthm.2026.01.025
Summarised from the published abstract; every number is checked against it