{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:40:18Z","timestamp":1789432818615,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T00:00:00Z","timestamp":1605225600000},"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":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Literature supports the existence of drivers as maintainers of atrial fibrillation (AF). Whether ultrahigh density (UHD) contact mapping may detect them is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We sequentially mapped the left atrial (LA) activation during spontaneous persistent AF and performed circumferential pulmonary vein isolation (CPVI), followed by remapping and ablation of potential drivers (rotational and focal propagation sites) with Rhythmia\u2122 in 90 patients. The time reference was an LA appendage (LAA) electrogram (EGM). Regions with uniform color were defined as \u201corganized.\u201d Only patients (51) with no previous ablation were considered for acute results and follow\u2010up reporting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>LA maps (175\u2009\u00b1\u200928\u2009ml, 43578\u2009\u00b1\u200918013 EGM) were acquired in 23\u2009\u00b1\u20097\u2009min. In all post\u2010CPVI maps potential drivers (7.3\u2009\u00b1\u20093.2\/patient) were visualized: 85% with rotational propagation and continuous low voltage in the center; the remaining with focal propagation and an organized EGM at the site of earliest activation. The RF delivery time for extra\u2010PV driver ablation was 12.2\u2009\u00b1\u20097.9\u2009min. There was a progressive increase of AF organization: the LAA cycle length prolonged, the number of potential drivers decreased, and the organized LA surface in AF increased from 14\u2009\u00b1\u20096% to 28\u2009\u00b1\u200916% (<jats:italic>p<\/jats:italic>\u2009=\u2009.0007). Termination of AF without cardioversion was obtained in 67%. AF recurrence rate at 15\u2009\u00b1\u20097.3 months was 17.6% after the first procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sequential UHD contact activation mapping of persistent AF allows visualization of potential drivers. A sequential strategy of CPVI followed by ablation of potential drivers with limited RF time resulted in an increasing organization of AF and good acute and long\u2010term results.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14803","type":"journal-article","created":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T06:45:32Z","timestamp":1604645132000},"page":"29-40","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Sequential ultrahigh\u2010density contact mapping of persistent atrial fibrillation: An efficient technique for driver identification"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6395-7190","authenticated-orcid":false,"given":"Decebal G.","family":"La\u021bcu","sequence":"first","affiliation":[{"name":"Centre Hospitalier Princesse Grace  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