{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T05:52:28Z","timestamp":1750830748911,"version":"3.40.5"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T00:00:00Z","timestamp":1642032000000},"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":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Some of atrial fibrillation (AF) drivers are found in normal\/mild late\u2010gadolinium enhancement (LGE) areas, as well as moderate ones. The atrial wall thickness (AWT) has been reported to be important as a possible AF substrate. However, the AWT and degree of LGEs as an AF substrate has not been fully validated in humans.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The purpose of this study was to evaluate the impact of the AWT in normal\/mild LGE areas on AF drivers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 287\u00a0segments in 15 persistent AF patients were assessed. AF drivers were defined as non\u2010passively activated areas (NPAs), where rotational activation was frequently observed, and were detected by the novel real\u2010time phase mapping (ExTRa Mapping), mild LGE areas were defined as areas with a volume ratio of the enhancement voxel of 0% to &lt;10%. The AWT was defined as the minimum distance from the manually determined endocardium to the epicardial border on the LGE\u2010MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>NPAs were found in 20 (18.0%) of 131 normal\/mild LGE areas where AWT was significantly thicker than that in the passively activated areas (PAs) (2.5\u00a0\u00b1\u00a00.3 vs. 2.2\u00a0\u00b1\u00a00.3\u00a0mm, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). However, NPAs were found in 41 (26.3%) of 156\u00a0moderate LGE areas where AWT was thinner than that of PAs (2.1\u00a0\u00b1\u00a00.2\u00a0mm vs. 2.23\u00a0\u00b1\u00a00.3\u00a0mm, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.02). An ROC curve analysis yielded an optimal cutoff value of 2.2\u00a0mm for predicting the presence of an NPA in normal\/mild LGE areas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The location of AF drivers in normal\/mild LGE areas might be more accurately identified by evaluating AWT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.12676","type":"journal-article","created":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T09:05:34Z","timestamp":1642064734000},"page":"221-231","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The impact of the atrial wall thickness in normal\/mild late\u2010gadolinium enhancement areas on atrial fibrillation rotors in persistent atrial fibrillation patients"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0521-3008","authenticated-orcid":false,"given":"Toshihiro","family":"Nakamura","sequence":"first","affiliation":[{"name":"Section of Arrhythmia Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9305-4854","authenticated-orcid":false,"given":"Kunihiko","family":"Kiuchi","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Fukuzawa","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuru","family":"Takami","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiaki","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Radiology Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Izawa","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Takemoto","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Sakai","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsusuke","family":"Yatomi","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Sonoda","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine  Kobe 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