{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:50:19Z","timestamp":1791949819135,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"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":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Arrhythmogenic substrates within the atrial myocardium may contribute to the initiation of atrial fibrillation (AF). The relationship between nonuniform isochrone\u2010areas in late activation mapping and arrhythmogenic substrates remains undetermined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010two patients (66\u2009\u00b1\u200910 years, 47 males, non\u2010paroxysmal AF [\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930], second ablation procedure [\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098]) who undergoing catheter ablation for AF were enrolled. High\u2010density left atrial (LA) activation mapping was performed during atrial pacing after pulmonary vein (PV) isolation. Late activation mapping was retrospectively reconstructed. Nonuniform isochrone\u2010areas were defined as regions of nonuniform and mottled conduction\u2010zones characterized by the crowding of \u2265\u20093 color\u2010isochrones within a 1\u2010cm radius in late activation mapping. The relationship between nonuniform isochrone\u2010areas and arrhythmogenic substrates associated with AF was evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Non\u2010PV triggers were identified in 11 patients (AF\u2010triggers:12; short runs of premature atrial complexes:4), located in the LA wall (posterior:7; anterior:6; septum:2; roof:1). Patients with non\u2010PV triggers had significantly more nonuniform isochrone\u2010areas than those without (median [interquartile range] 5.0 [3.0\u20136.0] vs. 2.0 [1.0\u20134.0],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In multivariate logistic analysis for the presence of non\u2010PV triggers, after adjusting for confounders such as non\u2010paroxysmal AF, heart failure\u2010history, and presence of low\u2010voltage areas, the presence of nonuniform isochrone\u2010areas on the LA low\u2010posterior wall was an independent indicator for the presence of non\u2010PV triggers (odds ratio: 6.9 [95% CI:1.1\u201344.1],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040). Of the 52 nonuniform isochrone\u2010areas observed in the 11 patients with non\u2010PV triggers, 20 areas corresponded to non\u2010PV trigger sites.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Identification of nonuniform isochrone\u2010areas located on LA low\u2010posterior wall in late activation mapping may indicate the potential source for non\u2010PV triggers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70417","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:07:13Z","timestamp":1782857233000},"page":"2183-2192","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Relationship Between Nonuniform Isochrone\u2010Area in Late Activation Mapping and Arrhythmogenic Substrates Related to Atrial Fibrillation"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8044-1575","authenticated-orcid":false,"given":"Tomonori","family":"Watanabe","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine Jichi Medical University School of Medicine Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Kamioka","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine Jichi Medical University School of Medicine Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5302-2874","authenticated-orcid":false,"given":"Hisaki","family":"Makimoto","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine Jichi Medical University School of Medicine Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Okuyama","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine Jichi Medical University School of Medicine Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine Jichi Medical University School of Medicine Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayako","family":"Yokota","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine Jichi Medical University School of Medicine Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2591-0433","authenticated-orcid":false,"given":"Takahiro","family":"Komori","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine Jichi Medical University School of Medicine Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5439-4303","authenticated-orcid":false,"given":"Tomoyuki","family":"Kabutoya","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine Jichi Medical University School of Medicine Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Hachiya","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine Jichi Medical University School of Medicine Tochigi Japan"},{"name":"Cardiovascular Center, Tsuchiura Kyodo Hospital Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Imai","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine Jichi Medical University School of Medicine Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8251-4480","authenticated-orcid":false,"given":"Kazuomi","family":"Kario","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine Jichi Medical University School of Medicine Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1161\/01.CIR.98.10.946","article-title":"Impact of Atrial Fibrillation on the Risk of Death: The Framingham Heart Study","volume":"98","author":"Benjamin E. 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G.","year":"2021","journal-title":"EP Europace"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1161\/CIRCULATIONAHA.119.042423","article-title":"Targeted Ablation of Ventricular Tachycardia Guided by Wavefront Discontinuities During Sinus Rhythm: A New Functional Substrate Mapping Strategy","volume":"140","author":"Aziz Z.","year":"2019","journal-title":"Circulation"},{"key":"e_1_2_11_11_1","first-page":"390","article-title":"Relationship Between Sinus Rhythm Late Activation Zones and Critical Sites for Scar\u2010Related Ventricular Tachycardia: Systematic Analysis of Isochronal Late Activation Mapping","volume":"8","author":"Irie T.","year":"2015","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1161\/01.CIR.0000090688.49283.67","article-title":"Electrical Remodeling of the Atria in Congestive Heart Failure: Electrophysiological and Electroanatomic Mapping in Humans","volume":"108","author":"Sanders P.","year":"2003","journal-title":"Circulation"},{"key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.jacc.2004.10.035","article-title":"Pre\u2010Existent Left Atrial Scarring in Patients Undergoing Pulmonary Vein Antrum Isolation","volume":"45","author":"Verma A.","year":"2005","journal-title":"Journal of the American College of Cardiology"},{"key":"e_1_2_11_14_1","first-page":"825","article-title":"Tailored Atrial Substrate Modification Based on Low\u2010Voltage Areas in Catheter Ablation of Atrial Fibrillation","volume":"7","author":"Rolf S.","year":"2014","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"key":"e_1_2_11_15_1","article-title":"Relationship Between Fractionated Signal Areas in the Atrial Muscle During Sinus Rhythm and Atrial Pacing and Non\u2010Pulmonary Vein Foci: Novel Mapping Strategy","volume":"13","author":"Hirokami J.","year":"2020","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.015927","article-title":"Additional Low\u2010Voltage\u2010Area Ablation in Patients With Paroxysmal Atrial Fibrillation: Results of the Randomized Controlled VOLCANO Trial","volume":"9","author":"Masuda M.","year":"2020","journal-title":"Journal of the American Heart Association"},{"key":"e_1_2_11_17_1","article-title":"Efficacy of Low\u2010Voltage\u2010Area Ablation Is Enhanced in Patients With Advanced Left Atrial Enlargement: A Subanalysis of the SUPPRESS\u2010AF Trial","volume":"18","author":"Masuda M.","year":"2025","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"key":"e_1_2_11_18_1","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2021.759967","article-title":"Extra\u2010Pulmonary Vein Triggers at De Novo and the Repeat Atrial Fibrillation Catheter Ablation","volume":"8","author":"Kim D.","year":"2021","journal-title":"Frontiers in Cardiovascular Medicine"},{"key":"e_1_2_11_19_1","first-page":"999","article-title":"Mechanisms of Long\u2010Term Recurrence 3 Years After Catheter Ablation of Atrial Fibrillation","volume":"6","author":"Park J. 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J.","year":"2023","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1016\/j.hrthm.2024.09.017","article-title":"The Functional Substrate in Patients With Atrial Fibrillation Is Predictive of Recurrences After Catheter Ablation","volume":"22","author":"Frontera A.","year":"2025","journal-title":"Heart Rhythm"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70417","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.70417","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70417","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:42:40Z","timestamp":1791949360000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.70417"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":24,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/jce.70417"],"URL":"https:\/\/doi.org\/10.1111\/jce.70417","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]},"assertion":[{"value":"2025-09-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}