{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:26:43Z","timestamp":1791239203730,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,25]],"date-time":"2019-11-25T00:00:00Z","timestamp":1574640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Isolation of the left atrial appendage (LAA) is often performed in persistent atrial fibrillation (AF). Propagation patterns in the LAA during AF remain to be elucidated. We sought to characterize propagation patterns in the LAA during AF in persistent AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Persistent AF patients undergoing catheter ablation were studied. Pulmonary vein isolation (PVI) was performed during continuous AF. If AF was not terminated by PVI, bi\u2010atrial mapping was performed using a multi\u2010electrode catheter during AF. Maps were collected at each site for 30\u2009seconds and analyzed offline with a novel software, CARTOFINDER. This software made automatic determinations of whether activation was focal or rotational. The left atrium (LA) was divided into five regions, of which the LAA was one, and the right atrium (RA) into three.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty patients were studied (62\u2009\u00b1\u200910 years, 65 males). On average, 9.6\u2009\u00b1\u20092.2 and 4.1\u2009\u00b1\u20091.2 maps were created in the LA and RA, respectively. The LAA was mapped in 70 patients, resulting in 85 maps. In the LAA, activation was identified as focal more often than rotational (64 [91%] vs 10 [14%] patients, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), seven patients displayed both. The number of focal activation events was greatest in the LAA (28.5 events\/30\u2009seconds [interquartile range, 15\u201054]) of the eight atrial regions. During focal activation, sites designated as earliest activation frequently covered a wide area, rather than being localized to a discrete site (5.4\u2009\u00b1\u20093.1 electrodes).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results of this study suggest that focal activation is a major mechanism underlying the arrhythmogenicity of the LAA in persistent AF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14278","type":"journal-article","created":{"date-parts":[[2019,11,14]],"date-time":"2019-11-14T12:24:29Z","timestamp":1573734269000},"page":"112-118","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Endocardial contact mapping of the left atrial appendage in persistent atrial fibrillation"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0335-996X","authenticated-orcid":false,"given":"Yoshihide","family":"Takahashi","sequence":"first","affiliation":[{"name":"Department of Advanced Arrhythmia Research Tokyo Medical and Dental University Tokyo Japan"},{"name":"Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kikou","family":"Akiyoshi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Sekigawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuhiko","family":"Yagishita","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasuku","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Advanced Arrhythmia Research Tokyo Medical and Dental University Tokyo Japan"},{"name":"Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihoko","family":"Kawabata","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Goya","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenzo","family":"Hirao","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3582-6104","authenticated-orcid":false,"given":"Tetsuo","family":"Sasano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo 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