{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:17:45Z","timestamp":1790716665623,"version":"4.1.0"},"reference-count":79,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002996","name":"Netherlands Heart Foundation","doi-asserted-by":"publisher","award":["0-005-2025-0146"],"award-info":[{"award-number":["0-005-2025-0146"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003246","name":"Dutch Research Council","doi-asserted-by":"publisher","award":["NWA . 1389 . 20 . 157"],"award-info":[{"award-number":["NWA . 1389 . 20 . 157"]}],"id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","heartrhythmjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Heart Rhythm"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.hrthm.2026.08.053","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:14:21Z","timestamp":1788448461000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Focal activation patterns in atrial fibrillation: Are we seeing the same across mapping methods?"],"prefix":"10.1016","author":[{"given":"Jiahao","family":"Zheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Knops","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell M.","family":"de Boer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vehpi","family":"Yildirim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathijs S.","family":"van Schie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0259-6691","authenticated-orcid":false,"given":"Natasja M.S.","family":"de Groot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.hrthm.2026.08.053_bib1","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1161\/01.CIR.89.4.1665","article-title":"High-density mapping of electrically induced atrial fibrillation in humans","volume":"89","author":"Konings","year":"1994","journal-title":"Circulation"},{"key":"10.1016\/j.hrthm.2026.08.053_bib2","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1016\/j.hrthm.2024.11.012","article-title":"Atrial fibrillation nomenclature, definitions, and mechanisms: position paper from the International Working Group of the Signal Summit","volume":"22","author":"de Groot","year":"2025","journal-title":"Heart Rhythm"},{"key":"10.1016\/j.hrthm.2026.08.053_bib3","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1161\/CIRCEP.109.910125","article-title":"Electropathological substrate of long-standing persistent atrial fibrillation in patients with structural heart disease: longitudinal dissociation","volume":"3","author":"Allessie","year":"2010","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib4","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1161\/01.CIR.95.3.572","article-title":"A focal source of atrial fibrillation treated by discrete radiofrequency ablation","volume":"95","author":"Ja\u00efs","year":"1997","journal-title":"Circulation"},{"key":"10.1016\/j.hrthm.2026.08.053_bib5","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1111\/jce.12000","article-title":"Acute termination of human atrial fibrillation by identification and catheter ablation of localized rotors and sources: first multicenter experience of Focal Impulse and Rotor Modulation (FIRM) ablation","volume":"23","author":"Shivkumar","year":"2012","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib6","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.117.005258","article-title":"Identification and characterization of sites where persistent atrial fibrillation is terminated by localized ablation","volume":"11","author":"Zaman","year":"2018","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib7","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1093\/europace\/euab254","volume":"24","author":"de Groot","year":"2022","journal-title":"Europace"},{"key":"10.1016\/j.hrthm.2026.08.053_bib8","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1111\/j.1540-8167.1994.tb01197.x","article-title":"Radiofrequency catheter ablation in unusual mechanisms of atrial fibrillation: report of three cases","volume":"5","author":"Ha\u00efssaguerre","year":"1994","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib9","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1056\/NEJM199809033391003","article-title":"Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins","volume":"339","author":"Ha\u00efssaguerre","year":"1998","journal-title":"N Engl J Med"},{"key":"10.1016\/j.hrthm.2026.08.053_bib10","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1161\/CIRCULATIONAHA.109.910901","article-title":"Electropathological substrate of longstanding persistent atrial fibrillation in patients with structural heart disease: epicardial breakthrough","volume":"122","author":"de Groot","year":"2010","journal-title":"Circulation"},{"key":"10.1016\/j.hrthm.2026.08.053_bib11","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.115.003648","article-title":"Direct proof of endo-epicardial asynchrony of the atrial wall during atrial fibrillation in humans","volume":"9","author":"de Groot","year":"2016","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib12","doi-asserted-by":"crossref","first-page":"2390","DOI":"10.1093\/eurheartj\/ehv233","article-title":"Atrial fibrillation driven by micro-anatomic intramural re-entry revealed by simultaneous sub-epicardial and sub-endocardial optical mapping in explanted human hearts","volume":"36","author":"Hansen","year":"2015","journal-title":"Eur Heart J"},{"key":"10.1016\/j.hrthm.2026.08.053_bib13","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1080\/14779072.2018.1485488","article-title":"Focal activation patterns: Breaking new grounds in the pathophysiology of atrial fibrillation","volume":"16","author":"Kharbanda","year":"2018","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"10.1016\/j.hrthm.2026.08.053_bib14","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1111\/jce.16568","article-title":"AF-FLOW Global Registry confirms validity of electrographic flow mapping as a phenotyping tool for atrial fibrillation","volume":"36","author":"Nilsson","year":"2025","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib15","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1046\/j.1540-8167.2004.03436.x","article-title":"On the atrial response to focal discharges in man","volume":"15","author":"Ramanna","year":"2004","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib16","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1016\/j.jacc.2005.12.068","article-title":"Sites of focal atrial activity characterized by endocardial mapping during atrial fibrillation","volume":"47","author":"Takahashi","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib17","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1161\/CIRCULATIONAHA.105.546648","article-title":"Localized sources maintaining atrial fibrillation organized by prior ablation","volume":"113","author":"Ha\u00efssaguerre","year":"2006","journal-title":"Circulation"},{"key":"10.1016\/j.hrthm.2026.08.053_bib18","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1111\/jce.13163","article-title":"Novel mapping technique for localization of focal and reentrant activation during atrial fibrillation","volume":"28","author":"Takahashi","year":"2017","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib19","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1111\/jce.13415","article-title":"Efficacy of catheter ablation of focal sources in persistent atrial fibrillation","volume":"29","author":"Takahashi","year":"2018","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib20","doi-asserted-by":"crossref","first-page":"2704","DOI":"10.1111\/jce.14214","article-title":"Identification of repetitive atrial activation patterns in persistent atrial fibrillation by direct contact high-density electrogram mapping","volume":"30","author":"Wolf","year":"2019","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib21","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1111\/jce.14278","article-title":"Endocardial contact mapping of the left atrial appendage in persistent atrial fibrillation","volume":"31","author":"Takahashi","year":"2020","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib22","doi-asserted-by":"crossref","first-page":"2979","DOI":"10.3390\/jcm10132979","article-title":"Find me if you can: First clinical experience using the novel CARTOFINDER algorithm in a routine workflow for atrial fibrillation ablation","volume":"10","author":"Unland","year":"2021","journal-title":"J Clin Med"},{"key":"10.1016\/j.hrthm.2026.08.053_bib23","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s10840-022-01124-0","article-title":"Evaluation of arrhythmogenic foci using a novel automated detection algorithm and isoproterenol in persistent atrial fibrillation","volume":"65","author":"Sakamoto","year":"2022","journal-title":"J Interv Card Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib24","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1007\/s00380-021-01977-x","article-title":"Identification of high priority focal activations in persistent atrial fibrillation using a novel mapping strategy","volume":"37","author":"Shimojo","year":"2022","journal-title":"Heart Vessels"},{"key":"10.1016\/j.hrthm.2026.08.053_bib25","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.hroo.2022.04.003","article-title":"Long-term outcome of patients with long-standing persistent atrial fibrillation undergoing ablation guided by a novel high-density panoramic mapping system: a propensity score matching study","volume":"3","author":"Chang","year":"2022","journal-title":"Heart Rhythm O2"},{"key":"10.1016\/j.hrthm.2026.08.053_bib26","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2022.819429","article-title":"Structural remodeling and rotational activity in persistent\/long-lasting atrial fibrillation: Gender-effect differences and impact on post-ablation outcome","volume":"9","author":"R\u00edos-Mu\u00f1oz","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"10.1016\/j.hrthm.2026.08.053_bib27","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1111\/pace.14847","article-title":"The individual relationship between atrial fibrillation sources from CARTOFINDER mapping and atrial cardiomyopathy: The catch me if you can trial","volume":"46","author":"Guckel","year":"2023","journal-title":"Pacing Clin Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib28","article-title":"Selecting repetitive focal and rotational activation patterns with the highest probability of being a source of atrial fibrillation","volume":"7","author":"Hermans","year":"2024","journal-title":"J Mol Cell Cardiol Plus"},{"key":"10.1016\/j.hrthm.2026.08.053_bib29","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.124.012829","article-title":"Mapping-Guided Ablation for Persistent Atrial Fibrillation (MAP-AF): A multicenter, single-blind, randomized controlled trial","volume":"17","author":"Takahashi","year":"2024","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib30","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1111\/jce.16311","article-title":"Vein of Marshall chemical ablation decreases atrial fibrillation drivers detected by CARTOFINDER","volume":"35","author":"Hasebe","year":"2024","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib31","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1111\/jce.16159","article-title":"Reliable focal and rotational activations in CARTOFINDER mapping using the OctaRay catheter","volume":"35","author":"Kawaji","year":"2024","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib32","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1016\/j.hrthm.2019.12.011","article-title":"Focal source and trigger mapping in atrial fibrillation: Randomized controlled trial evaluating a novel adjunctive ablation strategy","volume":"17","author":"Chauhan","year":"2020","journal-title":"Heart Rhythm"},{"key":"10.1016\/j.hrthm.2026.08.053_bib33","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1111\/jce.14812","article-title":"Focal and pseudo\/rotational activations in human atrial fibrillation defined with automated periodicity mapping","volume":"32","author":"Nayyar","year":"2021","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib34","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1002\/joa3.12361","article-title":"Diverse activation patterns during persistent atrial fibrillation by noncontact charge-density mapping of human atrium","volume":"36","author":"Shi","year":"2020","journal-title":"J Arrhythm"},{"key":"10.1016\/j.hrthm.2026.08.053_bib35","doi-asserted-by":"crossref","first-page":"2393","DOI":"10.1111\/jce.15170","article-title":"Spatial and temporal variability of rotational, focal, and irregular activity: Practical implications for mapping of atrial fibrillation","volume":"32","author":"Pope","year":"2021","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib36","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1016\/j.hrthm.2021.02.014","article-title":"Individualized ablation strategy to treat persistent atrial fibrillation: core-to-boundary approach guided by charge-density mapping","volume":"18","author":"Shi","year":"2021","journal-title":"Heart Rhythm"},{"key":"10.1016\/j.hrthm.2026.08.053_bib37","doi-asserted-by":"crossref","first-page":"2948","DOI":"10.3390\/jcm11102948","article-title":"Atrial fibrillation global changes after pulmonary vein and posterior wall isolation: A charge density mapping study","volume":"11","author":"Pannone","year":"2022","journal-title":"J Clin Med"},{"key":"10.1016\/j.hrthm.2026.08.053_bib38","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.121.021166","article-title":"Impact of adenosine on wavefront propagation in persistent atrial fibrillation: Insights from global noncontact charge density mapping of the left atrium","volume":"11","author":"Pope","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.hrthm.2026.08.053_bib39","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/j.1540-8167.2006.00682.x","article-title":"High-density mapping of spontaneous pulmonary vein activity initiating atrial fibrillation in humans","volume":"18","author":"Arentz","year":"2007","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib40","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0046034","article-title":"Computational mapping identifies localized mechanisms for ablation of atrial fibrillation","volume":"7","author":"Narayan","year":"2012","journal-title":"PLoS One"},{"key":"10.1016\/j.hrthm.2026.08.053_bib41","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1111\/j.1540-8167.2012.02332.x","article-title":"Clinical mapping approach to diagnose electrical rotors and focal impulse sources for human atrial fibrillation","volume":"23","author":"Narayan","year":"2012","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib42","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/j.jacc.2012.05.022","article-title":"Treatment of atrial fibrillation by the ablation of localized sources: CONFIRM (Conventional Ablation for Atrial Fibrillation With or Without Focal Impulse and Rotor Modulation) trial","volume":"60","author":"Narayan","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib43","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1093\/europace\/eut038","article-title":"Non-invasive identification of stable rotors and focal sources for human atrial fibrillation: Mechanistic classification of atrial fibrillation from the electrocardiogram","volume":"15","author":"Jones","year":"2013","journal-title":"Europace"},{"key":"10.1016\/j.hrthm.2026.08.053_bib44","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1161\/CIRCEP.111.977264","article-title":"Panoramic electrophysiological mapping but not electrogram morphology identifies stable sources for human atrial fibrillation: stable atrial fibrillation rotors and focal sources relate poorly to fractionated electrograms","volume":"6","author":"Narayan","year":"2013","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib45","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1161\/CIRCEP.113.001289","article-title":"Human atrial fibrillation initiates via organized rather than disorganized mechanisms","volume":"7","author":"Schricker","year":"2014","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib46","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1111\/jce.13177","article-title":"Two independent mapping techniques identify rotational activity patterns at sites of local termination during persistent atrial fibrillation","volume":"28","author":"Alhusseini","year":"2017","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib47","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1007\/s00392-018-1274-7","article-title":"Identification of active atrial fibrillation sources and their discrimination from passive rotors using electrographical flow mapping","volume":"107","author":"Bellmann","year":"2018","journal-title":"Clin Res Cardiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib48","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.jacep.2017.09.177","article-title":"A novel mapping system for panoramic mapping of the left atrium: application to detect and characterize localized sources maintaining atrial fibrillation","volume":"4","author":"Honarbakhsh","year":"2018","journal-title":"JACC Clin Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib49","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.117.005846","article-title":"Interaction of localized drivers and disorganized activation in persistent atrial fibrillation: reconciling putative mechanisms using multiple mapping techniques","volume":"11","author":"Kowalewski","year":"2018","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib50","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1111\/jce.13446","article-title":"Independent mapping methods reveal rotational activation near pulmonary veins where atrial fibrillation terminates before pulmonary vein isolation","volume":"29","author":"Navara","year":"2018","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib51","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.jacep.2017.06.005","article-title":"Transient rotor activity during prolonged 3-dimensional phase mapping in human persistent atrial fibrillation","volume":"4","author":"Pathik","year":"2018","journal-title":"JACC Clin Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib52","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.hrthm.2017.09.010","article-title":"Absence of rotational activity detected using 2-dimensional phase mapping in the corresponding 3-dimensional phase maps in human persistent atrial fibrillation","volume":"15","author":"Pathik","year":"2018","journal-title":"Heart Rhythm"},{"key":"10.1016\/j.hrthm.2026.08.053_bib53","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1111\/jce.13742","article-title":"Characterization and significance of localized sources identified by a novel automated algorithm during mapping of human persistent atrial fibrillation","volume":"29","author":"Verma","year":"2018","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib54","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1111\/jce.13752","article-title":"Automated detection of repetitive focal activations in persistent atrial fibrillation: Validation of a novel detection algorithm and application through panoramic and sequential mapping","volume":"30","author":"Honarbakhsh","year":"2019","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib55","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.118.006835","article-title":"Wavefront field mapping reveals a physiologic network between drivers where ablation terminates atrial fibrillation","volume":"12","author":"Leef","year":"2019","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib56","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1111\/pace.13649","article-title":"Comparing phase and electrographic flow mapping for persistent atrial fibrillation","volume":"42","author":"Swerdlow","year":"2019","journal-title":"Pacing Clin Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib57","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1111\/pace.14708","article-title":"Safety and efficacy of catheter ablation on patients with persistent atrial fibrillation by targeting repetitive activation patterns and focal impulses","volume":"46","author":"de Potter","year":"2023","journal-title":"Pacing Clin Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib58","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1053\/euhj.1999.1851","article-title":"Endocardial mapping of atrial fibrillation in the human right atrium using a non-contact catheter","volume":"21","author":"Schilling","year":"2000","journal-title":"Eur Heart J"},{"key":"10.1016\/j.hrthm.2026.08.053_bib59","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1161\/01.CIR.104.3.297","article-title":"Simultaneous noncontact mapping of left atrium in patients with paroxysmal atrial fibrillation","volume":"104","author":"Hindricks","year":"2001","journal-title":"Circulation"},{"key":"10.1016\/j.hrthm.2026.08.053_bib60","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.ijcard.2016.11.085","article-title":"Panoramic characterization of endocardial left atrial activation during human persistent AF: Insights from non-contact mapping","volume":"228","author":"Lee","year":"2017","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib61","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.120.008512","article-title":"Endocardial-epicardial phase mapping of prolonged persistent atrial fibrillation recordings: High prevalence of dissociated activation patterns","volume":"13","author":"Parameswaran","year":"2020","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib62","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1016\/j.hrthm.2024.01.039","article-title":"Spatial and temporal relationship between focal and rotational activations and their relationship to structural remodeling in patients with persistent atrial fibrillation","volume":"21","author":"Honarbakhsh","year":"2024","journal-title":"Heart Rhythm"},{"key":"10.1016\/j.hrthm.2026.08.053_bib63","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/0003-4975(95)00824-1","article-title":"Atrial activation during chronic atrial fibrillation in patients with isolated mitral valve disease","volume":"61","author":"Harada","year":"1996","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.hrthm.2026.08.053_bib64","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1093\/oxfordjournals.eurheartj.a015233","article-title":"Epicardial right atrial free wall mapping in chronic atrial fibrillation. Documentation of repetitive activation with a focal spread\u2014a hitherto unrecognised phenomenon in man","volume":"18","author":"Holm","year":"1997","journal-title":"Eur Heart J"},{"key":"10.1016\/j.hrthm.2026.08.053_bib65","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1046\/j.1540-8167.2002.00571.x","article-title":"Simultaneous biatrial computerized mapping during permanent atrial fibrillation in patients with organic heart disease","volume":"13","author":"Wu","year":"2002","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib66","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/S0003-4975(02)03696-2","article-title":"Efficacy of intraoperative mapping to optimize the surgical ablation of atrial fibrillation in cardiac surgery","volume":"74","author":"Yamauchi","year":"2002","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.hrthm.2026.08.053_bib67","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1016\/j.jtcvs.2003.05.001","article-title":"Concurrent multiple left atrial focal activations with fibrillatory conduction and right atrial focal or reentrant activation as the mechanism in atrial fibrillation","volume":"127","author":"Nitta","year":"2004","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.hrthm.2026.08.053_bib68","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.jtcvs.2004.09.012","article-title":"Map-guided surgery for atrial fibrillation","volume":"129","author":"Nitta","year":"2005","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.hrthm.2026.08.053_bib69","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1016\/j.athoracsur.2013.05.063","article-title":"Reentrant and focal activations during atrial fibrillation in patients with atrial septal defect","volume":"96","author":"Nitta","year":"2013","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.hrthm.2026.08.053_bib70","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1093\/eurheartj\/eht267","article-title":"Epicardial wave mapping in human long-lasting persistent atrial fibrillation: Transient rotational circuits, complex wavefronts, and disorganized activity","volume":"35","author":"Lee","year":"2014","journal-title":"Eur Heart J"},{"key":"10.1016\/j.hrthm.2026.08.053_bib71","doi-asserted-by":"crossref","first-page":"2108","DOI":"10.1161\/CIRCULATIONAHA.115.017007","article-title":"Simultaneous biatrial high-density (510\u2013512 electrodes) epicardial mapping of persistent and long-standing persistent atrial fibrillation in patients: new insights into the mechanism of its maintenance","volume":"132","author":"Lee","year":"2015","journal-title":"Circulation"},{"key":"10.1016\/j.hrthm.2026.08.053_bib72","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.jacep.2015.02.012","article-title":"Temporal stability of rotors and atrial activation patterns in persistent human atrial fibrillation: A high-density epicardial mapping study of prolonged recordings","volume":"1","author":"Walters","year":"2015","journal-title":"JACC Clin Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib73","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.116.005274","article-title":"Characterization of foci and breakthrough sites during persistent and long-standing persistent atrial fibrillation in patients: Studies using high-density (510\u2013512 electrodes) biatrial epicardial mapping","volume":"6","author":"Lee","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.hrthm.2026.08.053_bib74","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1016\/j.jacep.2020.12.010","article-title":"New insights into understanding rotor versus focal activation in patients with persistent atrial fibrillation","volume":"7","author":"Lee","year":"2021","journal-title":"JACC Clin Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib75","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1161\/CIRCULATIONAHA.110.945709","article-title":"Noninvasive characterization of epicardial activation in humans with diverse atrial fibrillation patterns","volume":"122","author":"Cuculich","year":"2010","journal-title":"Circulation"},{"key":"10.1016\/j.hrthm.2026.08.053_bib76","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1111\/jce.12075","article-title":"Noninvasive panoramic mapping of human atrial fibrillation mechanisms: A feasibility report","volume":"24","author":"Haissaguerre","year":"2013","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib77","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1161\/CIRCULATIONAHA.113.005421","article-title":"Driver domains in persistent atrial fibrillation","volume":"130","author":"Haissaguerre","year":"2014","journal-title":"Circulation"},{"key":"10.1016\/j.hrthm.2026.08.053_bib78","doi-asserted-by":"crossref","DOI":"10.1111\/anec.12527","article-title":"Noninvasive phase mapping of persistent atrial fibrillation in humans: Comparison with invasive catheter mapping","volume":"23","author":"Metzner","year":"2018","journal-title":"Ann Noninvasive Electrocardiol"},{"key":"10.1016\/j.hrthm.2026.08.053_bib79","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.017789","article-title":"Unmasking arrhythmogenic hubs of reentry driving persistent atrial fibrillation for patient-specific treatment","volume":"9","author":"Hansen","year":"2020","journal-title":"J Am Heart Assoc"}],"container-title":["Heart Rhythm"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S154752712602758X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S154752712602758X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:42:56Z","timestamp":1790714576000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S154752712602758X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":79,"alternative-id":["S154752712602758X"],"URL":"https:\/\/doi.org\/10.1016\/j.hrthm.2026.08.053","relation":{},"ISSN":["1547-5271"],"issn-type":[{"value":"1547-5271","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Focal activation patterns in atrial fibrillation: Are we seeing the same across mapping methods?","name":"articletitle","label":"Article Title"},{"value":"Heart Rhythm","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.hrthm.2026.08.053","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Heart Rhythm Society.","name":"copyright","label":"Copyright"}]}}