Evidence map›Paper›PMID 40071310›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 Cardiology2025

Identifying extra pulmonary vein targets for persistent atrial fibrillation ablation: bridging advanced and conventional mapping techniques.

Alexander J Sharp, Michael T Pope, Andre Briosa E Gala, Richard Varini, Abhirup Banerjee, Timothy R Betts

Abstract readComparative Study
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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Termination of atrial arrhythmia and restoration of sinus rhythm during pulsed field ablation with a pentaspline catheter in patients with persistent 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 · 2025
    Trial
  2. Review
  3. Article
  4. 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

6 authors.

Alexander J SharpInstitute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX37 DQ, UK.ORCID 0000-0002-5994-7798
Michael T PopeCardiology Department, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.ORCID 0000-0002-4166-3746
Andre Briosa E GalaCardiology Department, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.ORCID 0000-0002-9145-6374
Richard VariniCardiology Department, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK.ORCID 0009-0007-0783-3389
Abhirup BanerjeeInstitute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX37 DQ, UK.ORCID 0000-0001-8198-5128
Timothy R BettsCardiology Department, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK.ORCID 0000-0001-9063-9905

Funding

TRD - VisualizationP41GM103545 · NIGMS · UNIVERSITY OF UTAH · PI JURRUS, ELIZABETH · 2012 to 2019
$9.7M
Population-Based Shape and Biomechanical Analysis of Hip PathoanatomyR01EB016701 · NIBIB · UNIVERSITY OF UTAH · PI ANDERSON, ANDREW EDWARD · 2013 to 2023
$3.6M
ShapeWorks in the CloudR01AR076120 · NIAMS · UNIVERSITY OF UTAH · PI ELHABIAN, SHIREEN YOUSSEF · 2019 to 2024
$2.7M
Center for Integrative Biomedical Computing Legacy TransitionR24GM136986 · NIGMS · UNIVERSITY OF UTAH · PI JOHNSON, CHRISTOPHER R., MACLEOD, ROB S. · 2020 to 2022
$1.6M
New 3D and 4D Image-Based Clinical Measures of Atrial Structural and Functional Remodeling in Atrial FibrillationR01HL135568 · NHLBI · UNIVERSITY OF UTAH · PI CATES, JOSHUA E, ELHABIAN, SHIREEN YOUSSEF · 2017 to 2020
$1.4M
ShapeWorksStudio: An Integrative, User-Friendly, and Scalable Suite for Shape Representation and AnalysisU24EB029011 · NIBIB · UNIVERSITY OF UTAH · PI ELHABIAN, SHIREEN YOUSSEF · 2019 to 2023
$1.4M
NHLBI NIH HHS R01 HL135568NIAMS NIH HHS R01 AR076120NIBIB NIH HHS R01 EB016701NIBIB NIH HHS U24 EB029011NIGMS NIH HHS P41 GM103545NIGMS NIH HHS R24 GM136986NIH HHS NIBIB-U24EB029011ShapeWorks
6 · The paper itself

Abstract

aimsAdvanced technologies such as charge density mapping (CDM) show promise in guiding adjuvant ablation in patients with persistent atrial fibrillation (AF); however, their limited availability restricts widespread adoption. We sought to determine whether regions of the left atrium containing CDM-identified pivoting and rotational propagation patterns during AF could also be reliably identified using more conventional contact mapping techniques. METHODS AND

resultsTwenty-two patients undergoing de novo ablation of persistent AF underwent both CDM and electroanatomic voltage mapping during AF and sinus rhythm with multiple pacing protocols. Through the use of a left atrium statistical shape model, the location of distinctive propagation patterns identified by CDM was compared with low-voltage areas (LVAs) and regions of slow conduction velocity (CV). Neither LVA nor CV mapping during paced rhythms reliably identified regions containing CDM propagation patterns. Conduction velocity mapping during AF did correlate with these regions (ρ = -0.63, P < 0.0001 for pivoting patterns; ρ = -0.54, P < 0.0001 for rotational patterns). These propagation patterns consistently occurred in two specific anatomical regions across patients: the anteroseptal and inferoposterior walls of the left atrium.

conclusionMapping techniques during paced rhythms do not reliably correspond with regions of CDM-identified propagation patterns in persistent AF. However, these propagation patterns are consistently observed in two specific anatomical regions, suggesting a predisposition to abnormal electrophysiological properties. While further research is needed, these regions may serve as promising targets for empirical ablation, potentially reducing the reliance on complex mapping techniques.

Indexed as

Atrial FibrillationCatheter AblationElectrophysiologic Techniques, CardiacHeart AtriaPulmonary VeinsAction PotentialsAgedFemaleHeart RateHumansMaleMiddle AgedPredictive Value of TestsTreatment OutcomeCatheter ablationCharge density mappingConduction velocityElectroanatomic voltage mappingLow-voltage areasPersistent atrial fibrillation

Identifiers

PMID40071310
PMCPMC11953006

What OpenQuestion holds

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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.