ArticleJACC. Clinical electrophysiology2018
Human Atrial Fibrillation Drivers Resolved With Integrated Functional and Structural Imaging to Benefit Clinical Mapping.
Article in JACC. Clinical electrophysiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
55 citing papers in PubMed, 68 citations in OpenAlex.
- Prospective Randomized Trial of Rotor Ablation vs Conventional Ablation for Persistent Atrial Fibrillation: REAFFIRM Trial.Journal of the American Heart Association · 2025Trial
- Catheter configuration for mapping micro-anatomic reentries sustaining atrial fibrillation: A simulation study.PLoS computational biology · 2026Article
- Panoramic hyperspectral optical mapping of cardiac membrane potential and tissue type.Journal of biomedical optics · 2026Article
- Epicardial-to-Endocardial Activation Gradients and Conduction Block During Atrial Fibrillation in the Human Left Atrial Posterior Wall.Circulation. Arrhythmia and electrophysiology · 2026Article
- Understanding Atrial Fibrillation Complexity Through the Lens of Turbulence Dynamics: Implications for Treatment Strategies.Journal of cardiovascular electrophysiology · 2026Review
- Calcium Homeostatic Feedback Control Predicts Atrial Fibrillation Initiation, Remodeling, and Progression.JACC. Clinical electrophysiology · 2025Article
- Automatic Bi-Atrial Segmentation and Biomarker Extraction from Late Gadolinium-Enhanced MRI Using Deep Learning.Expert systems with applications · 2025Article
- Persistent atrial fibrillation ablation: glimpsing the light ahead?Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Review
- Atrial fibrillation nomenclature, definitions, and mechanisms: Position paper from the international Working Group of the Signal Summit.Heart rhythm · 2025Review
- Statistics and behavior of clinically significant extra-pulmonary vein atrial fibrillation sources: machine-learning-enhanced electrographic flow mapping in persistent atrial fibrillation.Frontiers in cardiovascular medicine · 2025Article
- Are drivers recurring or ephemeral? observations from serial mapping of persistent atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Isolated Perfused Hearts for Cardiovascular Research: An Old Dog with New Tricks.Journal of cardiovascular translational research · 2024Review
- Mechanistic Insights From Trials of Atrial Fibrillation Ablation: Charting a Course for the Future.Circulation. Arrhythmia and electrophysiology · 2024Review
- Navigating the Ebb and Flow of Atrial Fibrillation.JACC. Clinical electrophysiology · 2024Article
- Ibrutinib and atrial fibrillation: An in-depth review of clinical implications and management strategies.World journal of cardiology · 2024Review
- Spatially Conserved Spiral Wave Activity During Human Atrial Fibrillation.Circulation. Arrhythmia and electrophysiology · 2024Article
- Chamber-specific wall thickness features in human atrial fibrillation.Interface focus · 2023Article
- Electrographic flow mapping of persistent atrial fibrillation: intra- and inter-procedure reproducibility in the absence of 'ground truth'.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Mapping Atrial Fibrillation to Improve Ablation Outcomes.JAMA network open · 2023Article
- Electrographic flow mapping for atrial fibrillation: theoretical basis and preliminary observations.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2023Review
Corrections and comments
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Authors and funding
18 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivesThis study sought to improve atrial fibrillation (AF) driver identification by integrating clinical multielectrode mapping with driver fingerprints defined by high-resolution ex vivo 3-dimensional (3D) functional and structural imaging.
backgroundClinical multielectrode mapping of AF drivers suffers from variable contact, signal processing, and structural complexity within the 3D human atrial wall, raising questions on the validity of such drivers.
methodsSustained AF was mapped in coronary-perfused explanted human hearts (n = 11) with transmural near-infrared optical mapping (∼0.3 mm
resultsDuring sustained AF, near-infrared optical mapping identified 1 to 2 intramural, spatially stable re-entrant AF drivers per heart. Driver targeted ablation affecting 2.2 ± 1.1% of the atrial surface terminated and prevented AF. Driver regions had significantly higher phase singularity density and dominant frequency than neighboring nondriver regions. Focal Impulse and Rotor Mapping had 80% sensitivity to near-infrared optical mapping-defined driver locations (16 of 20), and matched 14 of 20 driver visualizations: 10 of 14 re-entries seen with Rotational Activity Profile; and 4 of 6 breakthrough/focal patterns. Focal Impulse and Rotor Mapping detected 1.1 ± 0.9 false-positive rotational activity profiles per recording, but these regions had lower intramural contrast-enhanced cardiac magnetic resonance imaging fibrosis than did driver regions (14.9 ± 7.9% vs. 23.2 ± 10.5%; p < 0.005).
conclusionsThe study revealed that both re-entrant and breakthrough/focal AF driver patterns visualized by surface-only clinical multielectrodes can represent projections of 3D intramural microanatomic re-entries. Integration of multielectrode mapping and 3D fibrosis analysis may enhance AF driver detection, thereby improving the efficacy of driver-targeted ablation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.