ArticleJACC. Clinical electrophysiology2021
New Insights Into Understanding Rotor Versus Focal Activation in Patients With Persistent Atrial Fibrillation.
Article in JACC. Clinical electrophysiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 6 citations in OpenAlex.
- Multimodal Characterization of Atrial Fibrillation: From Patient-Specific Anatomy and Electrophysiology to Standardized Atrial Mapping.Tomography (Ann Arbor, Mich.) · 2026Review
- Catheter configuration for mapping micro-anatomic reentries sustaining atrial fibrillation: A simulation study.PLoS computational biology · 2026Article
- Maintenance of atrial fibrillation by reciprocal triggering of competitive focal sources: a hypothesis.Frontiers in cardiovascular medicine · 2026Review
- Atrial fibrillation nomenclature, definitions, and mechanisms: Position paper from the international Working Group of the Signal Summit.Heart rhythm · 2025Review
- "Pharmacological" analysis of atrial fibrillation maintenance mechanism: reentry, wavelets, or focal?Frontiers in cardiovascular medicine · 2025Review
- An Evaluation of Phase Analysis to Interpret Atrial Activation Patterns during Persistent Atrial Fibrillation for Targeted Ablation.Journal of clinical medicine · 2022Article
- Reliable pace termination of postoperative atrial fibrillation in the canine sterile pericarditis model: Implications for atypical atrial flutter.Heart rhythm O2 · 2022Article
- Asymptomatic left circumflex artery stenosis is associated with higher arrhythmia recurrence after persistent atrial fibrillation ablation.Frontiers in cardiovascular medicine · 2022Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesThis study was to test the hypotheses that: 1) when using phase analysis, repetitive Wannabe re-entry produces a phase singularity point (i.e., a rotor); and 2) the location of the stable rotor is close to the focal source.
backgroundRecent contact mapping studies in patients with persistent atrial fibrillation (AF) demonstrated that phase analysis produced a different mechanistic result than classical activation sequence analysis. Our studies in patients with persistent AF showed that focal sources sometimes produced repetitive Wannabe re-entry, that is, incomplete re-entry.
methodsDuring open heart surgery, we recorded activation from both atria simultaneously using 510 to 512 electrodes in 12 patients with persistent AF. We performed activation sequence mapping and phase analyses on 4 s of mapped data. For each detected stable rotor (>2 full rotations [720°] recurring at the same site), the corresponding activation patterns were examined from the activation sequence maps.
resultsDuring AF, phase singularity points (rotors) were identified in both atria in all patients. However, stable phase singularity points were only present in 6 of 12 patients. The range of stable phase singularity points per patient was 0 to 6 (total 14). Stable phase singularity points were produced due to repetitive Wannabe re-entry generated from a focal source or by passive activation. A conduction block sometimes created a stable phase singularity point (n = 2). The average distance between a focal source and a stable rotor was 0.9 ± 0.3 cm.
conclusionsRepetitive Wannabe re-entry generated stable rotors adjacent to a focal source. No true re-entry occurred.
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