Evidence map›Paper›PMID 34260134›Full record

ArticleJournal of cardiovascular electrophysiology2021

Spatial and temporal variability of rotational, focal, and irregular activity: Practical implications for mapping of atrial fibrillation.

Michael Tb Pope, Pawel Kuklik, Andre Briosa E Gala, Milena Leo, Michael Mahmoudi, John Paisey, Timothy R Betts

Abstract read
In one paragraph

Article in Journal of cardiovascular electrophysiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed.

  1. Characteristics of rotational activation identified by the novel high-density ExTRa Mapping system.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Article
  2. Article
  3. Epicardial muscle bundles in persistent atrial fibrillation: from overlooked bystanders to arrhythmogenic modulators.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Review
  4. 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
  5. Review
  6. 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 · 2024
    Article
  7. Article
  8. 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 · 2023
    Article
  9. Article
  10. Review
  11. Article
  12. Review
  13. Article
  14. Is there rule to the chaos: Defining stable patterns in atrial fibrillation.Journal of cardiovascular electrophysiology · 2021
    Article
  15. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Michael Tb PopeDepartment of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.ORCID 0000-0002-4166-3746
Pawel KuklikDepartment of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany.
Andre Briosa E GalaDepartment of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.ORCID 0000-0002-9145-6374
Milena LeoDepartment of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.ORCID 0000-0001-6991-6664
Michael MahmoudiFaculty of Medicine, University of Southampton, Southampton, UK.
John PaiseyFaculty of Medicine, University of Southampton, Southampton, UK.
Timothy R BettsDepartment of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCharge density mapping of atrial fibrillation (AF) reveals dynamic localized rotational activation (LRA), irregular activation (LIA) and focal firing (FF). Their spatial stability, conduction characteristics and the optimal duration of mapping required to reveal these phenomena and has not been explored.

methodsBi-atrial mapping of AF propagation was undertaken using AcQMap (Acutus Medical) and variability of activation patterns quantified up to a duration of 30 s. The frequency of each pattern was quantified at each unique point of the chamber over two separate 30-s recordings before ablation and R

resultsIn 21 patients, 62 paired LA and RA maps were obtained. LIA was highly spatially stable with R

conclusionIrregular activation patterns characterized by changing wavefront direction are temporally and spatially stable in contrast with LRA that is transient with least spatial stability. Focal activation appears of intermediate stability. Regions of LIA show increased heterogeneity following extrastimulus pacing and may represent fixed anatomical substrate.

Indexed as

Atrial FibrillationCatheter AblationHeart AtriaHeart Conduction SystemHeart RateHumansAcQMapatrial fibrillationcharge density mappinglocalized irregular activationspatiotemporal stability

Identifiers

PMID34260134
PMCPMC9290790

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Registered trials

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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.