Evidence map›Paper›PMID 40917182›Full record

ArticleHeart rhythm O22025

Granger causality connectivity analysis of persistent atrial fibrillation dynamics reveals posterior wall mechanistic insights.

Joseph Barker, Arunashis Sau, Nikesh Bajaj, Alex Jenkins, Alex Sharp, Xili Shi, Xinyang Li, Nabeela Karim, Balvinder Handa, Richard Chambers and 4 more

Abstract read
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In one paragraph

Article in Heart rhythm O2, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Joseph BarkerNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Arunashis SauNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Nikesh BajajNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Alex JenkinsNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Alex SharpDepartment of Engineering Science, Institute of Biomechanical Engineering, University of Oxford, Oxford, United Kingdom.
Xili ShiNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Xinyang LiNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Nabeela KarimDepartment of Cardiology, Royal Brompton & Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
Balvinder HandaNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Richard ChambersAcutus Medical, Carlsbad, California.
Timothy BettsDivision of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom.
Nicholas S PetersNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Tom WongNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Fu Siong NgNational Heart and Lung Institute, Imperial College London, London, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Adjunctive posterior wall isolation (PWI) to pulmonary vein isolation (PVI) has not demonstrated convincing benefit during atrial fibrillation (AF) ablation. To provide mechanistic insight for null PWI trials, we undertook Granger causality (GC) analysis of noncontact left atrial (LA) electroanatomic maps. Objective: This study aimed to apply GC to intracardiac electrograms to uncover patient-specific AF dynamics and describe a proof-of-concept approach to targeted PWI after PVI. Methods: A prospective cohort study was undertaken at Royal Brompton Hospital. Consecutive patients undergoing PVI with noncontact mapping (AcQmap; Acutus Medical) before and after PVI were included. Results: In 21 patients, causality pairing index, a GC measure of organization, was unchanged after PVI (overall, 0.087 ± 0.012 vs 0.086 ± 0.015; Conclusion: GC provides mechanistic insight into the null trials for PWI and identifies a minority of patients who may benefit. GC is positioned as a clinical decision tool to guide personalized persistent AF ablation strategies.

Indexed as

Atrial fibrillationGranger causalityMechanismPosterior wall isolationPulmonary vein isolation

Identifiers

PMID40917182
PMCPMC12411957

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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.