ArticleFrontiers in physiology2020
Article in Frontiers in physiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Medical image analysis on left atrial LGE MRI for atrial fibrillation studies: A review.Medical image analysis · 2022Pooled it
- Multimodal Characterization of Atrial Fibrillation: From Patient-Specific Anatomy and Electrophysiology to Standardized Atrial Mapping.Tomography (Ann Arbor, Mich.) · 2026Review
- Optimal control of spiral waves in heterogeneous excitable media: non-monotonic efficacy of localized optogenetic inhibition.Journal of the Royal Society, Interface · 2026Article
- Transmural heterogeneity in 3D fibrosis distribution is associated with endo-epicardial electrical dyssynchrony in persistent atrial fibrillation.The Journal of physiology · 2026Article
- Prospective in silico trials identify combined SK and KThe Journal of physiology · 2026Article
- Towards mechanisms-driven strategy for persistent atrial fibrillation ablation: Leveraging digital twins.Journal of precision medicine (Amsterdam, Netherlands) · 2026Article
- Ablation of atrial fibrillation sources identified through sequential high-density mapping: in silico comparison against anatomy-based approaches.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 · 2026Article
- Automated generation of ablation lesion masks: a unison of electro and optic flow mapping for persistent AF virtual cohorts.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 · 2026Article
- The effect of clinically relevant changes in extracellular electrolyte concentrations on human atrial arrhythmias.Communications medicine · 2025Article
- Defining myocardial fiber bundle architecture in atrial digital twins.Computers in biology and medicine · 2025Article
- Digital twins as global learning health and disease models for preventive and personalized medicine.Genome medicine · 2025Review
- Medical Digital Twin: A Review on Technical Principles and Clinical Applications.Journal of clinical medicine · 2025Review
- DGM-TOP: automatic identification of the critical boundaries in atrial tachycardia.Frontiers in physiology · 2025Article
- Probing the limits and capabilities of diffusion models for the anatomic editing of digital twins.NPJ digital medicine · 2024Article
- Article
- In silico evaluation of cell therapy in acute versus chronic infarction: role of automaticity, heterogeneity and Purkinje in human.Scientific reports · 2024Article
- Computational modeling of cardiac electrophysiology and arrhythmogenesis: toward clinical translation.Physiological reviews · 2024Review
- Observable Atrial and Ventricular Fibrillation Episode Durations Are Conformant With a Power Law Based on System Size and Spatial Synchronization.Circulation. Arrhythmia and electrophysiology · 2024Article
- In Silico TRials guide optimal stratification of ATrIal FIbrillation patients to Catheter Ablation and pharmacological medicaTION: the i-STRATIFICATION 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 · 2024Article
- Digital twins in medicine.Nature computational science · 2024Review
Corrections and comments
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Authors and funding
15 authors at 3 institutions in 3 countries.
Funding
Abstract
Catheter ablation therapy for persistent atrial fibrillation (AF) typically includes pulmonary vein isolation (PVI) and may include additional ablation lesions that target patient-specific anatomical, electrical, or structural features. Clinical centers employ different ablation strategies, which use imaging data together with electroanatomic mapping data, depending on data availability. The aim of this study was to compare ablation techniques across a virtual cohort of AF patients. We constructed 20 paroxysmal and 30 persistent AF patient-specific left atrial (LA) bilayer models incorporating fibrotic remodeling from late-gadolinium enhancement (LGE) MRI scans. AF was simulated and post-processed using phase mapping to determine electrical driver locations over 15 s. Six different ablation approaches were tested: (i) PVI alone, modeled as wide-area encirclement of the pulmonary veins; PVI together with: (ii) roof and inferior lines to model posterior wall box isolation; (iii) isolating the largest fibrotic area (identified by LGE-MRI); (iv) isolating all fibrotic areas; (v) isolating the largest driver hotspot region [identified as high simulated phase singularity (PS) density]; and (vi) isolating all driver hotspot regions. Ablation efficacy was assessed to predict optimal ablation therapies for individual patients. We subsequently trained a random forest classifier to predict ablation response using (a) imaging metrics alone, (b) imaging and electrical metrics, or (c) imaging, electrical, and ablation lesion metrics. The optimal ablation approach resulting in termination, or if not possible atrial tachycardia (AT), varied among the virtual patient cohort: (i) 20% PVI alone, (ii) 6% box ablation, (iii) 2% largest fibrosis area, (iv) 4% all fibrosis areas, (v) 2% largest driver hotspot, and (vi) 46% all driver hotspots. Around 20% of cases remained in AF for all ablation strategies. The addition of patient-specific and ablation pattern specific lesion metrics to the trained random forest classifier improved predictive capability from an accuracy of 0.73 to 0.83. The trained classifier results demonstrate that the surface areas of pre-ablation driver regions and of fibrotic tissue not isolated by the proposed ablation strategy are both important for predicting ablation outcome. Overall, our study demonstrates the need to select the optimal ablation strategy for each patient. It suggests that both patient-specific fibrosis properties and driver locations are important for planning ablation approaches, and the distribution of lesions is important for predicting an acute response.
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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.