ArticleHeart rhythm O22023
Electrographic flow-guided ablation in redo patients with persistent atrial fibrillation (FLOW-AF): design and rationale.
Article in Heart rhythm O2, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04473963 (A Randomized Controlled Study to Evaluate the Reliability of Electrographic Flow™), which is not on this map. Cited by 9 papers.
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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.
A Randomized Controlled Study to Evaluate the Reliability of Electrographic Flow™ (EGF) Mapping Algorithm Technology to Identify Sources of Atrial Fibrillation and Guide Ablation Therapy in Patients With Persistent Atrial Fibrillation
Who cites it
9 citing papers in PubMed.
- A single-center trial of electrographic flow mapping and concomitant voltage mapping in sinus rhythm and atrial fibrillation (FLOW EVAL-AF).Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Trial
- Spatiotemporal Stability of Persistent Atrial Fibrillation Sources: Stable Source or Disease Progression?Journal of cardiovascular development and disease · 2026Article
- Electrographic flow (EGF) mapping reveals sex-based differences in EGF patterns with women concentrated in phenotypes that benefit from EGF-guided ablation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- An efficient end-to-end computational framework for the generation of ECG calibrated volumetric models of human atrial electrophysiology.Medical image analysis · 2026Article
- AF-FLOW Global Registry Confirms Validity of Electrographic Flow Mapping as a Phenotyping Tool for Atrial Fibrillation.Journal of cardiovascular electrophysiology · 2025Observational
- Electrographic flow mapping of atrial fibrillation.Current opinion in cardiology · 2025Review
- Statistics and behavior of clinically significant extra-pulmonary vein atrial fibrillation sources: machine-learning-enhanced electrographic flow mapping in persistent atrial fibrillation.Frontiers in cardiovascular medicine · 2025Article
- 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 · 2023Article
- Visualization of electrographic flow fields of increasing complexity and detection of simulated sources during spontaneously persistent AF in an animal model.Frontiers in cardiovascular medicine · 2023Article
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Electrographic flow (EGF) mapping enables the dynamic detection of functional or active atrial fibrillation (AF) sources outside the pulmonary veins (PVs), and the presence or absence of these sources offers a novel framework for classifying and treating persistent AF patients based on the underlying pathophysiology of their AF disease. Objective: The primary objective of the FLOW-AF trial is to evaluate the reliability of the EGF algorithm technology (Ablamap software) to identify AF sources and guide ablation therapy in patients with persistent AF. Methods: The FLOW-AF trial (NCT04473963) is a prospective, multicenter, randomized clinical study in which patients with persistent or long-standing persistent AF who have failed prior PV isolation (PVI) undergo EGF mapping after confirmation of intact PVI. In total, 85 patients will be enrolled and stratified based on the presence or absence of EGF-identified sources. Patients with an EGF-identified source above the predetermined activity threshold of ≥26.5% will be randomized in a 1:1 fashion to PVI only vs PVI + ablation of EGF-identified extra-PV sources of AF. Results: The primary safety endpoint is freedom from serious adverse events related to the procedure through 7 days following the randomization procedure; and the primary effectiveness endpoint is the successful elimination of significant sources of excitation with the target parameter the activity of the leading source. Conclusions: The FLOW-AF trial is a randomized study designed to evaluate the ability of the EGF mapping algorithm to identify patients with active extra-PV AF sources.
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