{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T13:34:35Z","timestamp":1786714475581,"version":"build-2736575974"},"reference-count":63,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical practice. Its incidence increases significantly with age and has become a major global public health issue. Although research into the mechanisms of AF has spanned over a century\u2010ranging from the reentry theory to the rotor hypothesis\u2010none of these theories can fully explain its complex dynamic characteristics. The electrical activity of AF exhibits similarities to fluid turbulence, and this analogy provides a new theoretical framework for understanding AF. This review systematically outlines the evolution of AF theories and analyzes the multidimensional connections between the electrophysiological properties of atrial myocardium and the principles of turbulence dynamics. These include the nonlinear propagation characteristics of electrical wavefronts, the impact of atrial tissue heterogeneity on wave conduction, and the therapeutic rationale of catheter ablation targeting the sources of turbulence. Based on this, the study proposes the hypothesis that cardiac electrical activity in AF resembles a turbulence\u2010like state, suggesting that AF fundamentally represents a nonlinear dynamic turbulence\u2010like phenomenon of myocardial excitation waves under certain conditions. This hypothesis posits that critical arrhythmogenic substrates in AF\u2014characterized by established structural and electrophysiological heterogeneities\u2014create conditions analogous to sites where turbulence dynamics emerge in fluid systems, providing a phenomenological framework for characterizing the spatial\u2010temporal organization underlying ablation therapy efficacy. By integrating traditional AF theories with fluid dynamics concepts of turbulence, this hypothesis holds promise for more comprehensively explaining the complex characteristics and individual variability of AF, thereby offering a new theoretical foundation for improving AF management outcomes.<\/jats:p>","DOI":"10.1111\/jce.70229","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T04:05:58Z","timestamp":1766376358000},"page":"400-412","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Understanding Atrial Fibrillation Complexity Through the Lens of Turbulence Dynamics: Implications for Treatment Strategies"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7665-9241","authenticated-orcid":false,"given":"Xin","family":"Chu","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Anhui Chest Hospital Hefei Anhui 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