{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T01:44:44Z","timestamp":1774575884476,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:00:00Z","timestamp":1679875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Identifying the critical isthmus region (CIR) of atrial re\u2010entry tachycardias (AT) is challenging. The Lumipoint\u00ae (LP) software, developed for the Rhythmia\u00ae mapping system, aims to facilitate the successful ablation of ATs by identifying the CIR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of this study was to evaluate the quality of LP regarding the percentage of arrhythmia\u2010relevant CIR in patients with atypical atrial flutter (AAF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective study, we analyzed 57 AAF forms. Electrical activity (EA) was mapped over tachycardia cycle length resulting in a two\u2010dimensional EA pattern. The hypothesis was that EA minima suggest potential CIRs with slow\u2010conduction\u2010zone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of <jats:italic>n<\/jats:italic>\u2009=\u200933 patients were included, with the majority of patients being already preablated (69.7%). LP algorithm identified a mean of 2.4 EA minima and 4.4 suggested CIRs per AAF form. Overall, we observed a low probability of identifying only the relevant CIR (POR) at 12.3% but a high probability that at least one CIR is detected (PALO) at 98.2%. Detailed analysis revealed EA minima depth (\u226420%) and width (&gt;50\u2009ms) as the best predictors of relevant CIRs. Wide minima occurred rarely (17.5%), while low minima were more frequently present (75.4%). Minima depth of EA\u2009\u2264\u200920% showed the best PALO\/POR overall (95% and 60%, respectively). Analysis in recurrent AAF ablations (five patients) revealed that CIR in de novo AAF was already detected by LP during the index procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The LP algorithm provides an excellent PALO (98.2%), but poor POR (12.3%) to detect the CIR in AAF. POR improved by preselection of the lowest and widest EA minima. In addition, there might be the role of initial bystander CIRs becoming relevant for future AAFs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.24009","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T09:42:50Z","timestamp":1679910170000},"page":"574-583","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Characterization of temporal electrical activity patterns for detection of critical isthmus regions of recurrent atypical atrial flutter"],"prefix":"10.1002","volume":"46","author":[{"given":"Nadine","family":"Vonderlin","sequence":"first","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, West\u2010German Heart and Vascular Center Essen, University of Essen Medical School University Duisburg\u2010Essen Essen Germany"},{"name":"German Centre for Cardiovascular Research (DZHK)  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Siebermair","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, West\u2010German Heart and Vascular Center Essen, University of Essen Medical School University Duisburg\u2010Essen Essen Germany"},{"name":"German Centre for Cardiovascular Research (DZHK)  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir","family":"Mahabadi","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, West\u2010German Heart and Vascular Center Essen, University of Essen Medical School University Duisburg\u2010Essen Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4467-8417","authenticated-orcid":false,"given":"Elena","family":"Pesch","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, West\u2010German Heart and Vascular Center Essen, University of Essen Medical School University Duisburg\u2010Essen Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Koehler","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, West\u2010German Heart and Vascular Center Essen, University of Essen Medical School University Duisburg\u2010Essen Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dobromir","family":"Dobrev","sequence":"additional","affiliation":[{"name":"Institute of Pharmacology, West German Heart and Vascular Center University Duisburg\u2010Essen  Essen Germany"},{"name":"Department of Molecular Physiology and Biophysics Baylor College of Medicine  Houston Texas USA"},{"name":"Department of Medicine and Research Center, Montreal Heart Institute Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf Alexander","family":"Janosi","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, West\u2010German Heart and Vascular Center Essen, University of Essen Medical School University Duisburg\u2010Essen Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tienush","family":"Rassaf","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, West\u2010German Heart and Vascular Center Essen, University of Essen Medical School University Duisburg\u2010Essen Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6326-1537","authenticated-orcid":false,"given":"Reza","family":"Wakili","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, West\u2010German Heart and Vascular Center Essen, University of Essen Medical School University Duisburg\u2010Essen Essen Germany"},{"name":"German Centre for Cardiovascular Research (DZHK)  Berlin Germany"},{"name":"Department of Cardiology and Vascular Medicine, University Hospital Frankfurt Goethe University Frankfurt Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2005.01.027"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.107.748160"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2008.01373.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.2174\/1573403X10666141013122400"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.109.899021"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI46315"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2010.01982.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2019.01.016"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2019.04.029"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.541052"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000146917.75041.58"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2007.01.021"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.116.004510"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euz154"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13035"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.10.029"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.117.006019"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.108.772392"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.05.072"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2005.00308.x"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14251"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.21037\/cdt.2019.10.02"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-16938-6"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euz144"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.24009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T17:51:18Z","timestamp":1692553878000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.24009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,27]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1002\/clc.24009"],"URL":"https:\/\/doi.org\/10.1002\/clc.24009","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,27]]},"assertion":[{"value":"2022-12-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}