Trial reportJACC. Clinical electrophysiology2024
A Randomized Trial of Electrographic Flow-Guided Redo Ablation for Nonparoxysmal Atrial Fibrillation (FLOW-AF).
Trial report in JACC. Clinical electrophysiology, 2024. 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 18 papers.
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.
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
18 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
- Editorial commentary: Pulsed field versus thermal ablation for atrial fibrillation.Trends in cardiovascular medicine · 2026Article
- 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
- Individualized dynamic ablation strategy for persistent atrial fibrillation based on ibutilide response.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2026Article
- Impact of Catheter Configuration on the Mapping of Atrial Fibrillation.Circulation. Arrhythmia and electrophysiology · 2026Article
- Artificial Intelligence-driven Detection, Mapping, and Personalized Therapy for Atrial Fibrillation.The Journal of innovations in cardiac rhythm management · 2026Review
- Repeat ablation for persistent atrial fibrillation: what lies beyond lines and veins?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 · 2025Article
- Targeting the Substrate: Mechanism-Based Ablation Strategies for Persistent Atrial Fibrillation.Journal of clinical medicine · 2025Review
- Persistent atrial fibrillation ablation: glimpsing the light ahead?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 · 2025Review
- AF-FLOW Global Registry Confirms Validity of Electrographic Flow Mapping as a Phenotyping Tool for Atrial Fibrillation.Journal of cardiovascular electrophysiology · 2025Observational
- Comparing Phenotypes for Acute and Long-Term Response to Atrial Fibrillation Ablation Using Machine Learning.Circulation. Arrhythmia and electrophysiology · 2025Article
- Electrographic Flow Mapping Provides Prognosis for AF Ablation Outcomes Across Two Independent Prospective Patient Cohorts.Journal of clinical medicine · 2025Article
- 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 atrial fibrillation.Current opinion in cardiology · 2025Review
- Evolution in electrophysiology 100 years after Einthoven: translational and computational innovations in rhythm control of atrial fibrillation.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 · 2024Review
- Catheter Ablation in Atrial Fibrillation: Recent Advances.Journal of clinical medicine · 2024Review
- Navigating the Ebb and Flow of Atrial Fibrillation.JACC. Clinical electrophysiology · 2024Article
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElectrographic flow (EGF) mapping enables full spatiotemporal reconstruction of organized wavefront propagation to identify extrapulmonary vein sources of atrial fibrillation (AF).
objectivesFLOW-AF (A Randomized Controlled Study to Evaluate the Reliability of the Ablacon Electrographic FLOW [EGF] Algorithm Technology [Ablamap Software] to Identify AF Sources and Guide Ablation Therapy in Patients With Persistent Atrial Fibrillation) was multicenter, randomized controlled study of EGF mapping to: 1) stratify a nonparoxysmal AF population undergoing redo ablation; 2) guide ablation of these extrapulmonary vein AF sources; and 3) improve AF recurrence outcomes.
methodsFLOW-AF enrolled persistent atrial fibrillation (PerAF)/long-standing PerAF patients undergoing redo ablation at 4 centers. One-minute EGF maps were recorded from standardized biatrial basket positions. Patients with source activity ≥26.5% were randomized 1:1 to PVI + EGF-guided ablation vs PVI only; patients without sources ≥26.5% threshold were not randomized. Follow-up and electrocardiographic monitoring occurred at 3, 6, and 12 months.
resultsWe enrolled 85 patients (age 65.6 ± 9.3 years, 37% female, 24% long-standing PerAF). Thirty-four (40%) patients had no sources greater than threshold; at least 1 source greater than threshold was present in 46 (60%) (EGF-guided ablation, n = 22; control group, n = 26). Patients with sources were older (68.2 vs 62.6 years; P = 0.005) with higher CHA
conclusionsIn nonparoxysmal AF patients undergoing redo ablation, EGF mapping identified AF sources in 60% of patients, and could be successfully ablated in 95%. Compared with PVI alone, PVI + source ablation improved AF-free survival by 51% on an absolute basis. (FLOW-AF: A Study to Evaluate the Ablacon Electrographic FLOW EGF Technology [A Randomized Controlled Study to Evaluate the Reliability of the Ablacon Electrographic FLOW (EGF) Algorithm Technology (Ablamap Software) to Identify AF Sources and Guide Ablation Therapy in Patients With Persistent Atrial Fibrillation]; NCT04473963).
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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.