{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T15:50:01Z","timestamp":1757778601835,"version":"3.37.3"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T00:00:00Z","timestamp":1557100800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100001316","name":"Abbott","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001316","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Clinical outcomes after radiofrequency catheter ablation (RFCA) remain suboptimal in the treatment of non-paroxysmal atrial fibrillation (AF). Electrophysiological mapping may improve understanding of the underlying mechanisms. To describe the arrhythmia substrate in patients with persistent (Pers) and long-standing persistent (LSPers) AF, undergoing RFCA, using an integrated mechanism mapping technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Patients underwent high-density electroanatomical mapping before and after catheter ablation. Integrated maps characterized electrogram (EGM) cycle length (CL) in regions with repetitive\u2013regular (RR) activations, stable wavefront propagation, fragmentation, and peak-to-peak bipolar voltage. Among 83 patients (72% male, 60\u2009\u00b1\u200911\u2009years old), RR activations were identified in 376 regions (mean CL 180\u2009\u00b1\u200931\u2009ms). PersAF patients (n\u2009=\u200943) showed more RR sites per patient (5.3\u2009\u00b1\u20092.4 vs. 3.7\u2009\u00b1\u20092.1, P\u2009=\u20090.002) with faster CL (166\u2009\u00b1\u200929 vs. 190\u2009\u00b1\u200929\u2009ms; P\u2009&lt;\u20090.001) and smaller surface area of fragmented EGMs (15\u2009\u00b1\u200914% vs. 27\u2009\u00b1\u200917%, P\u2009&lt;\u20090.001) compared with LSPersAF. The post-ablation map in 50 patients remaining in AF, documented reduction of the RR activities per patient (1.5\u2009\u00b1\u20090.7 vs. 3.7\u2009\u00b1\u20091.4, P\u2009&lt;\u20090.001) and area of fragmentation (22\u2009\u00b1\u200917% vs. 8\u2009\u00b1\u20099%, P\u2009&lt;\u20090.001). Atrial fibrillation termination during ablation occurred at RR sites (0.48\u2009\u00b1\u20090.24\u2009mV; 170.5\u2009\u00b1\u200920.2\u2009ms CL) in 31\/33 patients (94%). At the latest follow-up, arrhythmia freedom was higher among patients receiving ablation &gt;75% of RR sites (Q4 82.6%, Q3 63.1%, Q2 35.1%, and Q1 0%; P\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The integrated mapping technique allowed characterization of multiple arrhythmic substrates in non-paroxysmal AF patients. This technique might serve as tool for a substrate-targeted ablation approach.<\/jats:p><\/jats:sec>","DOI":"10.1093\/europace\/euz123","type":"journal-article","created":{"date-parts":[[2019,4,12]],"date-time":"2019-04-12T19:18:29Z","timestamp":1555096709000},"page":"1193-1202","source":"Crossref","is-referenced-by-count":5,"title":["Non-paroxysmal atrial fibrillation mapping: characterization of the electrophysiological substrate using a novel integrated mapping technique"],"prefix":"10.1093","volume":"21","author":[{"given":"Giuseppe","family":"Ciconte","sequence":"first","affiliation":[{"name":"Department of Arrhythmology, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Vicedomini","sequence":"additional","affiliation":[{"name":"Department of Arrhythmology, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenwen","family":"Li","sequence":"additional","affiliation":[{"name":"Applied Research, Abbott, Sylmar, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan O","family":"Mangual","sequence":"additional","affiliation":[{"name":"Applied Research, Abbott, Sylmar, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke","family":"McSpadden","sequence":"additional","affiliation":[{"name":"Applied Research, Abbott, Sylmar, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyungmoo","family":"Ryu","sequence":"additional","affiliation":[{"name":"Applied Research, Abbott, Sylmar, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Saviano","sequence":"additional","affiliation":[{"name":"Department of Arrhythmology, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Vitale","sequence":"additional","affiliation":[{"name":"Department of Arrhythmology, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Conti","sequence":"additional","affiliation":[{"name":"Department of Arrhythmology, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u017darko","family":"\u0106alovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Arrhythmology, IRCCS Policlinico San Donato, Piazza E. 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