{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:26:55Z","timestamp":1790364415204,"version":"4.1.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T00:00:00Z","timestamp":1660003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"European Union's Horizon"},{"name":"Marie Sk\u0142odowska-Curie","award":["766082"],"award-info":[{"award-number":["766082"]}]},{"name":"EMPIR programme"},{"name":"European Union\u2019s Horizon"},{"name":"MedalCare"},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["391128822"],"award-info":[{"award-number":["391128822"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The long-term success rate of ablation therapy is still sub-optimal in patients with persistent atrial fibrillation (AF), mostly due to arrhythmia recurrence originating from arrhythmogenic sites outside the pulmonary veins. Computational modelling provides a framework to integrate and augment clinical data, potentially enabling the patient-specific identification of AF mechanisms and of the optimal ablation sites. We developed a technology to tailor ablations in anatomical and functional digital atrial twins of patients with persistent AF aiming to identify the most successful ablation strategy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Twenty-nine patient-specific computational models integrating clinical information from tomographic imaging and electro-anatomical activation time and voltage maps were generated. Areas sustaining AF were identified by a personalized induction protocol at multiple locations. State-of-the-art anatomical and substrate ablation strategies were compared with our proposed Personalized Ablation Lines (PersonAL) plan, which consists of iteratively targeting emergent high dominant frequency (HDF) regions, to identify the optimal ablation strategy. Localized ablations were connected to the closest non-conductive barrier to prevent recurrence of AF or atrial tachycardia. The first application of the HDF strategy had a success of &amp;gt;98% and isolated only 5\u20136% of the left atrial myocardium. In contrast, conventional ablation strategies targeting anatomical or structural substrate resulted in isolation of up to 20% of left atrial myocardium. After a second iteration of the HDF strategy, no further arrhythmia episode could be induced in any of the patient-specific models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The novel PersonAL in silico technology allows to unveil all AF-perpetuating areas and personalize ablation by leveraging atrial digital twins.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euac116","type":"journal-article","created":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T14:03:09Z","timestamp":1660053789000},"page":"211-222","source":"Crossref","is-referenced-by-count":71,"title":["Personalized ablation vs. conventional ablation strategies to terminate atrial fibrillation and prevent recurrence"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2919-4617","authenticated-orcid":false,"given":"Luca","family":"Azzolin","sequence":"first","affiliation":[{"name":"Institute of Biomedical Engineering at Karlsruhe Institute of Technology , Building 30.33, Fritz-Haber-Weg 1, 76131 Karlsruhe , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3674-790X","authenticated-orcid":false,"given":"Martin","family":"Eichenlaub","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen , Suedring 15, 79189 Bad Krozingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Nagel","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering at Karlsruhe Institute of Technology , Building 30.33, Fritz-Haber-Weg 1, 76131 Karlsruhe , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Nairn","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering at Karlsruhe Institute of Technology , Building 30.33, Fritz-Haber-Weg 1, 76131 Karlsruhe , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering at Karlsruhe Institute of Technology , Building 30.33, Fritz-Haber-Weg 1, 76131 Karlsruhe , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Unger","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering at Karlsruhe Institute of Technology , Building 30.33, Fritz-Haber-Weg 1, 76131 Karlsruhe , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4551-7970","authenticated-orcid":false,"given":"Olaf","family":"D\u00f6ssel","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering at Karlsruhe Institute of Technology , Building 30.33, Fritz-Haber-Weg 1, 76131 Karlsruhe , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Jadidi","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen , Suedring 15, 79189 Bad Krozingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Loewe","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering at Karlsruhe Institute of Technology , Building 30.33, Fritz-Haber-Weg 1, 76131 Karlsruhe , 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