Evidence map›Paper›PMID 30895945›Full record

Trial reportJCI insight2019

High-resolution noncontact charge-density mapping of endocardial activation.

Andrew Grace, Stephan Willems, Christian Meyer, Atul Verma, Patrick Heck, Min Zhu, Xinwei Shi, Derrick Chou, Lam Dang, Christoph Scharf and 2 more

Registry-linked trialAbstract readClinical TrialVideo-Audio Media
In one paragraph

Trial report in JCI insight, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01875614, which is not on this map. Cited by 49 papers.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

NCT01875614 no registry record found
3 · Its place in the literature

Who cites it

49 citing papers in PubMed.

  1. Article
  2. Article
  3. Identifying extra pulmonary vein targets for persistent atrial fibrillation ablation: bridging advanced and conventional mapping techniques.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 · 2025
    Article
  4. Article
  5. Article
  6. 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 · 2024
    Article
  7. Article
  8. Article
  9. Advanced Electroanatomic Mapping: Current and Emerging Approaches.Current treatment options in cardiovascular medicine · 2024
    Article
  10. 2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of 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 · 2024
    Article
  11. Article
  12. Article
  13. The performance of dipole charge density mapping integrated with robotic magnetic navigation in the treatment of atrial tachycardias.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2023
    Article
  14. A single-beat algorithm to discriminate farfield from nearfield bipolar voltage electrograms from the pulmonary veins.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2023
    Article
  15. Review
  16. Treatment of pathophysiologic propagation outside of the pulmonary veins in retreatment of atrial fibrillation patients: RECOVER AF study.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 · 2023
    Article
  17. Electrocardiographic imaging in the atria.Medical & biological engineering & computing · 2023
    Review
  18. Rotor mechanism and its mapping in 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 · 2023
    Review
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Andrew GraceRoyal Papworth Hospital Foundation Trust, Cambridge University Health Partners, Cambridge, United Kingdom.
Stephan WillemsUniversity Heart Center, University Hospital, Hamburg-Eppendorf, Hamburg, Germany.
Christian MeyerUniversity Heart Center, University Hospital, Hamburg-Eppendorf, Hamburg, Germany.
Atul VermaSouthlake Regional Health Center, Newmarket, University of Toronto, Ontario, Canada.
Patrick HeckRoyal Papworth Hospital Foundation Trust, Cambridge University Health Partners, Cambridge, United Kingdom.
Min ZhuAcutus Medical Inc., Carlsbad, California, USA.
Xinwei ShiAcutus Medical Inc., Carlsbad, California, USA.
Derrick ChouAcutus Medical Inc., Carlsbad, California, USA.
Lam DangCardiovascular Center, Klinik im Park, Zürich, Switzerland.
Christoph ScharfCardiovascular Center, Klinik im Park, Zürich, Switzerland.
Günter ScharfPhysics Institute, University of Zurich, Zurich, Switzerland.
Graydon BeattyAcutus Medical Inc., Carlsbad, California, USA.

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundSpatial resolution in cardiac activation maps based on voltage measurement is limited by far-field interference. Precise characterization of electrical sources would resolve this limitation; however, practical charge-based cardiac mapping has not been achieved.

methodsA prototype algorithm, developed from first principles of electrostatic field theory, derives charge density (CD) as a spatial representation of the true sources of the cardiac field. The algorithm processes multiple, simultaneous, noncontact voltage measurements within the cardiac chamber to inversely derive the global distribution of CD sources across the endocardial surface.

resultsComparison of CD to an established computer-simulated model of atrial conduction demonstrated feasibility in terms of spatial, temporal, and morphologic metrics. Inverse reconstruction matched simulation with median spatial errors of 1.73 mm and 2.41 mm for CD and voltage, respectively. Median temporal error was less than 0.96 ms and morphologic correlation was greater than 0.90 for both CD and voltage. Activation patterns observed in human atrial flutter reproduced those established through contact maps, with a 4-fold improvement in resolution noted for CD over voltage. Global activation maps (charge density-based) are reported in atrial fibrillation with confirmed reduction of far-field interference. Arrhythmia cycle-length slowing and termination achieved through ablation of critical points demonstrated in the maps indicates both mechanistic and pathophysiological relevance.

conclusionGlobal maps of cardiac activation based on CD enable classification of conduction patterns and localized nonpulmonary vein therapeutic targets in atrial fibrillation. The measurement capabilities of the approach have roles spanning deep phenotyping to therapeutic application.

trial registrationClinicalTrials.gov NCT01875614.

fundingThe National Institute for Health Research (NIHR) Translational Research Program at Royal Papworth Hospital and Acutus Medical.

Indexed as

Action PotentialsAdolescentAdultAgedAlgorithmsAtrial FibrillationAtrial FlutterComputer SimulationEchocardiographyElectrocardiographyElectrophysiologic Techniques, CardiacEndocardiumFeasibility StudiesFemaleHeart AtriaHeart RateArrhythmiasCardiologyCardiovascular disease

Identifiers

PMID30895945
PMCPMC6483005

What OpenQuestion holds

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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.