Evidence map›Paper›PMID 37961921›Full record

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

Functional mapping to reveal slow conduction and substrate progression in atrial fibrillation.

Etel Silva Garcia, Ivan Lobo-Torres, Juan Fernández-Armenta, Diego Penela, Marcos Fernandez-Garcia, Andrea Gomez-Lopez, David Soto-Iglesias, Rafael Fernández-Rivero, Rafael Vazquez-Garcia, Juan Acosta and 3 more

Registry-linked trialOpen access · hybridAbstract read
In one paragraph

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. It is linked to trial NCT06657170 (Hidden Slow Conduction Ablation for Recurrent Atrial Fibrillation), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.0field-weighted citation impact, top 12% of its field
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.

NCT06657170 nanot yet recruitingnot on this mapstarted 2024, after this paper: background citation

Hidden Slow Conduction Ablation for Recurrent Atrial Fibrillation: Unmasking the Arrhythmogenic Substrate

TypeinterventionalSponsorCentro Medico TeknonRan2024 to 2027Enrolled212ConditionsAtrial FibrillationArmsPulmunary veins reconnection plus hidden slow conduction ablation, Pulmunary veins (PV) reconnection ablation only
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Review
  2. 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
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 1 country.

Etel Silva GarciaDepartment of Cardiology, Hospital Universitario Puerta del Mar, Cádiz, Spain.ORCID 0000-0001-6825-243X
Ivan Lobo-TorresDepartment of Cardiology, Hospital Universitario Puerta del Mar, Cádiz, Spain.ORCID 0000-0002-9950-5628
Juan Fernández-ArmentaDepartment of Cardiology, Hospital Universitario Puerta del Mar, Cádiz, Spain.ORCID 0000-0003-1700-6604
Diego PenelaTeknon Medical Center, Heart Institute, Barcelona, Spain.ORCID 0009-0009-7221-4829
Marcos Fernandez-GarciaDepartment of Cardiology, Hospital Universitario Puerta del Mar, Cádiz, Spain.ORCID 0009-0000-0193-4540
Andrea Gomez-LopezDepartment of Cardiology, Hospital Universitario Puerta del Mar, Cádiz, Spain.
David Soto-IglesiasTeknon Medical Center, Heart Institute, Barcelona, Spain.ORCID 0000-0003-1394-6260
Rafael Fernández-RiveroDepartment of Cardiology, Hospital Universitario Puerta del Mar, Cádiz, Spain.
Rafael Vazquez-GarciaDepartment of Cardiology, Hospital Universitario Puerta del Mar, Cádiz, Spain.ORCID 0000-0001-8876-474X
Juan AcostaDepartment of Cardiology, Hospital Universitario Virgen del Rocío, Sevilla, Spain.ORCID 0000-0002-5634-7981
Felipe BisbalInstitut del Cor (iCor), Hospital Universitari Germans Trias i Pujol, Badalona, Spain.ORCID 0000-0002-4843-7063
Lucas Cano-CalabriaDepartment of Cardiology, Hospital Universitario Puerta del Mar, Cádiz, Spain.
Antonio BerruezoTeknon Medical Center, Heart Institute, Barcelona, Spain.ORCID 0000-0002-5418-383X
Hospital Universitario Puerta del Mar · ESHospital Quirón Teknon · ESHospital Universitario Virgen del Rocío · ESInstituto de Salud Carlos III · ES

Funding

Andalusian Regional Government PI-0057-2017European Regional Development FundEuropean Social FundHealth Council
6 · The paper itself

Abstract

aimsThe aim of our study was to analyse the response to short-coupled atrial extrastimuli to identify areas of hidden slow conduction (HSC) and their relationship with the atrial fibrillation (AF) phenotype. METHODS AND

resultsTwenty consecutive patients with paroxysmal AF and persistent AF (10:10) underwent the first pulmonary vein isolation procedure. Triple short-coupled extrastimuli were delivered in sinus rhythm (SR), and the evoked response was analysed: sites exhibiting double or highly fragmented electrograms (EGM) were defined as positive for HSC (HSC+). The delta of the duration of the bipolar EGM was analysed, and bipolar EGM duration maps were built. High-density maps were acquired using a multipolar catheter during AF, SR, and paced rhythm. Spatial co-localization of HSC+ and complex fractionated atrial EGMs (CFAE) during AF was evaluated. Persistent AF showed a higher number and percentage of HSC+ than paroxysmal AF (13.9% vs. 3.3%, P < 0.001). The delta of EGM duration was 53 ± 22 ms for HSC+ compared with 13 ± 11 (10) ms in sites with negative HSC (HSC-) (P < 0.001). The number and density of HSC+ were lower than CFAE during AF (19 vs. 56 per map, P < 0.001). The reproducibility and distribution of HSC+ in repeated maps were superior to CFAE (P = 0.19 vs. P < 0.001). Sites with negative and positive responses showed a similar bipolar voltage in the preceding sinus beat (1.65 ± 1.34 and 1.48 ± 1.47 mV, P = 0.12).

conclusionFunctional mapping identifies more discrete and reproducible abnormal substrates than mapping during AF. The HSC+ sites in response to triple extrastimuli are more frequent in persistent AF than in paroxysmal AF.

Indexed as

Atrial FibrillationCatheter AblationElectrophysiologic Techniques, CardiacHeart AtriaHeart RateHumansReproducibility of ResultsAtrial fibrillationFunctional mappingHidden slow conduction

Identifiers

PMID37961921
PMCPMC10644200
OpenAlexW4388673469

What OpenQuestion holds

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LicenceCC BY-NC
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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.