ArticleJournal of arrhythmia2026
Clinical Outcomes of High Density Voltage and Fractionation Mapping-Guided Ablation in Patients With Persistent Atrial Fibrillation.
Article in Journal of arrhythmia, 2026. 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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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.
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Authors and funding
4 authors.
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Abstract
Background: Catheter ablation outcomes remain suboptimal in patients with persistent atrial fibrillation (AF), and the optimal strategy beyond pulmonary vein isolation (PVI) has not been established. We evaluated whether a personalized strategy combining high-density voltage-guided segmental PVI and fractionation mapping-guided substrate modification improves clinical outcomes compared to anatomy-based circumferential PVI. Methods: This study prospectively enrolled 57 consecutive patients with persistent or long-standing persistent AF who underwent segmental PVI combined with fractionation mapping-guided ablation using the EnSite system (2019-2021). Clinical outcomes were compared with a retrospectively identified cohort of 57 patients who underwent anatomy-based circumferential PVI alone (2017-2021), matched for baseline characteristics. The primary endpoints were 1-year freedom from AF and AF/atrial tachycardia (AT) recurrence using Kaplan-Meier analysis and log-rank test. Multivariable Cox proportional hazard regression was performed to adjust for age and left atrial volume. Results: Kaplan-Meier analysis revealed that the intervention group had a significantly higher 1-year freedom from AF recurrence compared to the PVI only group (78.9% vs. 59.6%, log-rank Conclusions: In patients with persistent AF, high-density fractionation mapping-guided ablation in addition to segmental PVI was associated with improved 1-year freedom from AF. This tailored substrate modification strategy may enhance rhythm control in this challenging population.
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