Feasibility of unipolar signal–guided ablation in creating contiguous lines of conduction block: A proof-of-concept study

We demonstrate that Uni-_EGM can successfully guide ablation yielding conduction lines of block. Uni-_EGM morphology reflects local tissue activation, and its modification in response to thermal injury can serve as an endpoint to ensure adequate yet avoid excess RF delivery. The near-field S wave on the Uni-_EGM indicates viable tissue and, in conjunction with an acute current of injury, identified contiguous, conductive tissue for targeting. Characterization of Uni-_EGM morphology with respect to myocardial electrical properties and understanding its modification in response to injury may lend to the continued pursuit of safer, more effective ablation strategies.