ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2023
Personalized ablation vs. conventional ablation strategies to terminate atrial fibrillation and prevent recurrence.
Article in 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. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 4 of them syntheses 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, 4 syntheses or guidelines pooled it.
- Safety and efficacy of the pulsed field ablation for persistent atrial fibrillation: a meta-analysis.BMC cardiovascular disorders · 2026Pooled it
- Technologies, Clinical Applications, and Implementation Barriers of Digital Twins in Precision Cardiology: Systematic Review.JMIR cardio · 2026Pooled it
- Meta-analysis of the safety and efficacy between pulsed field ablation vs. traditional ablation for persistent atrial fibrillation.Frontiers in cardiovascular medicine · 2026Pooled it
- Regionalization of the atria for 3D electroanatomical mapping, cardiac imaging, and computational modelling: a clinical consensus statement of the European Heart Rhythm Association and the European Association of Cardiovascular Imaging of the ESC.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 · 2025Guideline
- Women with persistent atrial fibrillation need more than pulmonary vein isolation: personalised extra-pulmonary vein ablation strategy vs. pulmonary vein isolation alone in the TAILORED-AF trial.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 · 2025Trial
- The clinical pathophysiology of atrial fibrillation: outstanding questions from bedside to bench and back.Physiological reviews · 2026Review
- Role of interatrial connection ablation in re-entry dynamics: an in silico evaluation.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
- Towards mechanisms-driven strategy for persistent atrial fibrillation ablation: Leveraging digital twins.Journal of precision medicine (Amsterdam, Netherlands) · 2026Article
- T-World Virtual Human Cardiomyocyte. II. Organ-Scale Simulations and Applications.Circulation research · 2026Article
- Automatic Localization of Stable Highest Dominant Frequency Area in AF Patients Based on Spatial Aggregation.Bioengineering (Basel, Switzerland) · 2026Article
- Models of cardiomyocyte-non-myocyte electrical interactions.The Journal of physiology · 2026Review
- 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
- 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
- A scoping review of human digital twins in healthcare applications and usage patterns.NPJ digital medicine · 2025Article
- Role of Computational Modelling in Enhancing Thermal Safety During Cardiac Ablation.Interdisciplinary cardiovascular and thoracic surgery · 2025Review
- Digital Twin Models in Atrial Fibrillation: Charting the Future of Precision Therapy?Journal of personalized medicine · 2025Review
- Atrial fibrillation nomenclature, definitions, and mechanisms: Position paper from the international Working Group of the Signal Summit.Heart rhythm · 2025Review
- Challenges and Opportunities for Atrial Fibrillation Management.Cardiology discovery · 2025Review
- Computational modelling of biological systems now and then: revisiting tools and visions from the beginning of the century.Philosophical transactions. Series A, Mathematical, physical, and engineering sciences · 2025Review
- Advancing Atrial Fibrillation Research: The Role of Animal Models, Emerging Technologies and Translational Challenges.Biomedicines · 2025Review
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
aimsThe long-term success rate of ablation therapy is still sub-optimal in patients with persistent atrial fibrillation (AF), mostly due to arrhythmia recurrence originating from arrhythmogenic sites outside the pulmonary veins. Computational modelling provides a framework to integrate and augment clinical data, potentially enabling the patient-specific identification of AF mechanisms and of the optimal ablation sites. We developed a technology to tailor ablations in anatomical and functional digital atrial twins of patients with persistent AF aiming to identify the most successful ablation strategy. METHODS AND
resultsTwenty-nine patient-specific computational models integrating clinical information from tomographic imaging and electro-anatomical activation time and voltage maps were generated. Areas sustaining AF were identified by a personalized induction protocol at multiple locations. State-of-the-art anatomical and substrate ablation strategies were compared with our proposed Personalized Ablation Lines (PersonAL) plan, which consists of iteratively targeting emergent high dominant frequency (HDF) regions, to identify the optimal ablation strategy. Localized ablations were connected to the closest non-conductive barrier to prevent recurrence of AF or atrial tachycardia. The first application of the HDF strategy had a success of >98% and isolated only 5-6% of the left atrial myocardium. In contrast, conventional ablation strategies targeting anatomical or structural substrate resulted in isolation of up to 20% of left atrial myocardium. After a second iteration of the HDF strategy, no further arrhythmia episode could be induced in any of the patient-specific models.
conclusionThe novel PersonAL in silico technology allows to unveil all AF-perpetuating areas and personalize ablation by leveraging atrial digital twins.
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