{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:44:55Z","timestamp":1791985495548,"version":"4.4.0"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004331","name":"Johnson and Johnson","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004331","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":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Spectral analysis has been utilized to identify localized sites exhibiting high dominant frequency (DF) and high regularity\u2014the critical arrhythmogenic substrate driving atrial fibrillation (AF). This study aimed to elucidate the spectral characteristics of focal activation (FoA) and rotational activation (RoA) sites during AF using a high\u2010density mapping system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CARTOFINDER mapping was prospectively performed in both atria of 47 consecutive non\u2010paroxysmal AF patients using the Octaray catheter prior to ablation. Endocardial unipolar electrograms were exported offline for spectral analysis of DF and the regularity index (RI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CARTOFINDER assessed a total of 48\u2009153 mapping points. Given substantial inter\u2010subject variability in mean DF, the difference between each point's DF and the subject\u2010level mean DF was defined as the dominant frequency deviation (DFD). The left atrium (LA) demonstrated significantly higher DFD and RI than the right atrium (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with the LA roof recording the highest values across all segments. Both FoA and RoA sites exhibited significantly higher DFD and RI compared with sites without FoA and RoA (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). DFD and RI increased progressively with increasing FoA repetitions (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In contrast, high\u2010repetition RoA sites (&gt;\u200916 repetitions) showed a significantly higher RI (0.42\u2009\u00b1\u20090.13 vs. 0.36\u2009\u00b1\u20090.12,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) but a paradoxically lower DFD (0.14\u2009\u00b1\u20090.64\u2009Hz vs. 0.26\u2009\u00b1\u20090.74\u2009Hz,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared with low\u2010repetition RoA sites.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The combination of CARTOFINDER mapping and spectral analysis may contribute to the mechanistic understanding of non\u2010paroxysmal AF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.70477","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T08:02:12Z","timestamp":1789977732000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High\u2010Density Spectral Analysis for Bi\u2010Atrial Arrhythmogenic Substrate During Non\u2010Paroxysmal Atrial Fibrillation"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0045-8631","authenticated-orcid":false,"given":"Nobunari","family":"Tomura","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8597-7165","authenticated-orcid":false,"given":"Keitaro","family":"Senoo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kyoto Prefectural University of Medicine  Kyoto Japan"},{"name":"Department of Cardiac Arrhythmia Research and Innovation, Graduate School of Medical Sciences Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2671-6330","authenticated-orcid":false,"given":"Taku","family":"Ohkawa","sequence":"additional","affiliation":[{"name":"Department of Cardiac Arrhythmia Research and Innovation, Graduate School of Medical Sciences Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Kakei","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8885-2446","authenticated-orcid":false,"given":"Kohei","family":"Kawai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Makino","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Munakata","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2499-3476","authenticated-orcid":false,"given":"Tomonori","family":"Miki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Kyoto Tanabe Central Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8570-3561","authenticated-orcid":false,"given":"Yukinori","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Kyoto Chubu Medical Center  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kento","family":"Fukui","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Kyoto Okamoto Memorial Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Kitajima","sequence":"additional","affiliation":[{"name":"Beppu Medical Clinic  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3117-9985","authenticated-orcid":false,"given":"Suguru","family":"Nishiuchi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Gunma Prefectural Cardiovascular Center  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Kakita","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Koseikai Takeda Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2013-0606","authenticated-orcid":false,"given":"Daisuke","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tenyokai Central Hospital  Kagoshima 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