{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T02:34:26Z","timestamp":1788489266287,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T00:00:00Z","timestamp":1589932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005622","name":"Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005622","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Global simultaneous recording of atrial activation during atrial fibrillation (AF) can elucidate underlying mechanisms contributing to AF maintenance. A better understanding of these mechanisms may allow for an individualized ablation strategy to treat persistent AF. The study aims to characterize left atrial endocardial activation patterns during AF using noncontact charge\u2010density mapping.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010five patients with persistent AF were studied. Activation patterns were characterized into three subtypes: (i) focal with centrifugal activation (FCA); (ii) localized rotational activation (LRA); and (iii) localized irregular activation (LIA). Continuous activation patterns were analyzed and distributed in 18 defined regions in the left atrium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 144 AF segments with 1068 activation patterns were analyzed. The most common pattern during AF was LIA (63%) which consists of four disparate features of activation: slow conduction (45%), pivoting (30%), collision (16%), and acceleration (7%). LRA was the second\u2010most common pattern (20%). FCA accounted for 17% of all activations, arising frequently from the pulmonary veins (PVs)\/ostia. A majority of patients (24\/25; 96%) showed continuous and highly dynamic patterns of activation comprising multiple combinations of FCA, LRA, and LIA, transitioning from one to the other without a discernible order. Preferential conduction areas were typically seen in the mid\u2010anterior (48%) and lower\u2010posterior (40%) walls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Atrial fibrillation is characterized by heterogeneous activation patterns identified in PV\u2010ostia and non\u2010PV regions throughout the LA at varying locations between individuals. Clinical implications of individualized ablation strategies guided by charge\u2010density mapping need to be determined.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.12361","type":"journal-article","created":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T08:57:21Z","timestamp":1589965041000},"page":"692-702","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Diverse activation patterns during persistent atrial fibrillation by noncontact charge\u2010density mapping of human atrium"],"prefix":"10.1002","volume":"36","author":[{"given":"Rui","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine The First Affliated Hospital of Xi'an Jiaotong University Xi'an China"},{"name":"Heart Rhythm Centre The Royal Brompton and Harefield NHS Foundation Trust National Heart and Lung Institute Imperial College London London 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