{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T02:57:11Z","timestamp":1787540231487,"version":"build-2736575974"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T00:00:00Z","timestamp":1701648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000781","name":"The European Research Council","doi-asserted-by":"publisher","award":["716509"],"award-info":[{"award-number":["716509"]}],"id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003246","name":"Netherlands Organization for Scientific Research","doi-asserted-by":"publisher","award":["91714336"],"award-info":[{"award-number":["91714336"]}],"id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Diseased atria are characterized by functional and structural heterogeneities, adding to abnormal impulse generation and propagation. These heterogeneities are thought to lie at the origin of fractionated electrograms recorded during sinus rhythm (SR) in atrial fibrillation (AF) patients and are assumed to be involved in the onset and perpetuation (e.g. by re-entry) of this disorder. The underlying mechanisms, however, remain incompletely understood. Here, we tested whether regions of dense fibrosis could create an electrically isolated conduction pathway (EICP) in which re-entry could be established via ectopy and local block to become \u2018trapped\u2019. We also investigated whether this could generate local fractionated electrograms and whether the re-entrant wave could \u2018escape\u2019 and cause a global tachyarrhythmia due to dynamic changes at a connecting isthmus.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>To precisely control and explore the geometrical properties of EICPs, we used light-gated depolarizing ion channels and patterned illumination for creating specific non-conducting regions in silico and in vitro. Insight from these studies was used for complementary investigations in virtual human atria with localized fibrosis. We demonstrated that a re-entrant tachyarrhythmia can exist locally within an EICP with SR prevailing in the surrounding tissue and identified conditions under which re-entry could escape from the EICP, thereby converting a local latent arrhythmic source into an active driver with global impact on the heart. In a realistic three-dimensional model of human atria, unipolar epicardial pseudo-electrograms showed fractionation at the site of \u2018trapped re-entry\u2019 in coexistence with regular SR electrograms elsewhere in the atria. Upon escape of the re-entrant wave, acute arrhythmia onset was observed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Trapped re-entry as a latent source of arrhythmogenesis can explain the sudden onset of focal arrhythmias, which are able to transgress into AF. Our study might help to improve the effectiveness of ablation of aberrant cardiac electrical signals in clinical practice.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cvr\/cvad179","type":"journal-article","created":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T18:53:04Z","timestamp":1701715984000},"page":"249-261","source":"Crossref","is-referenced-by-count":10,"title":["\u2018Trapped re-entry\u2019 as source of acute focal atrial arrhythmias"],"prefix":"10.1093","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4942-9866","authenticated-orcid":false,"given":"Tim","family":"De Coster","sequence":"first","affiliation":[{"name":"Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, PO 9600, 2333 ZA Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7841-376X","authenticated-orcid":false,"given":"Alexander S","family":"Teplenin","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, PO 9600, 2333 ZA Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9645-6384","authenticated-orcid":false,"given":"Iolanda","family":"Feola","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, PO 9600, 2333 ZA Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy I","family":"Bart","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, PO 9600, 2333 ZA Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9036-6935","authenticated-orcid":false,"given":"Arti A","family":"Ramkisoensing","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, PO 9600, 2333 ZA Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9376-5931","authenticated-orcid":false,"given":"Bram L","family":"den Ouden","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, PO 9600, 2333 ZA Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6231-4297","authenticated-orcid":false,"given":"Dirk L","family":"Ypey","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, PO 9600, 2333 ZA Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7715-9536","authenticated-orcid":false,"given":"Serge A","family":"Trines","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, PO 9600, 2333 ZA Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2643-642X","authenticated-orcid":false,"given":"Alexander V","family":"Panfilov","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, PO 9600, 2333 ZA Leiden , The Netherlands"},{"name":"Department of Physics and Astronomy, Ghent University , 9000 Ghent , Belgium"},{"name":"Biomed Laboratory, Ural Federal University , 620002 Ekaterinburg , Russia"},{"name":"World-Class Research Center \u2018Digital Biodesign and Personalized Healthcare\u2019, I. 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