{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:27:23Z","timestamp":1791239243204,"version":"4.1.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Identification and elimination of nonpulmonary vein targets may improve clinical outcomes in patients with persistent atrial fibrillation (AF). We report on the use of a novel, noncontact imaging and mapping system that uses ultrasound to reconstruct atrial chamber anatomy and measures timing and density of dipolar, ionic activation (ie, charge density) across the myocardium to guide ablation of atrial arrhythmias.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>The prospective, nonrandomized UNCOVER AF trial (Utilizing Novel Dipole Density Capabilities to Objectively Visualize the Etiology of Rhythms in Atrial Fibrillation) was conducted at 13 centers across Europe and Canada. Patients with persistent AF (&gt;7 days, &lt;1 year) aged 18 to 80 years, scheduled for de novo catheter ablation, were eligible. Before pulmonary vein isolation, AF was mapped and then iteratively remapped to guide each subsequent ablation of charge density\u2013identified targets. AF recurrence was evaluated at 3, 6, 9, and 12 months using continuous 24-hour ECG monitors. The primary effectiveness outcome was freedom from AF &gt;30 seconds at 12 months for a single procedure with a secondary outcome being acute procedural efficacy. The primary safety outcome was freedom from device\/procedure-related major adverse events.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Between October 2016 and April 2017, 129 patients were enrolled, and 127 underwent mapping and catheter ablation. Acute procedural efficacy was demonstrated in 125 patients (98%). At 12 months, single procedure freedom from AF on or off antiarrhythmic drugs was 72.5% (95% CI, 63.9%\u201380.3%). After 1 or 2 procedures, freedom from AF was 93.2% (95% CI, 87.1%\u201397.0%). A total of 29 (23%) retreatments because of arrhythmia recurrence were performed with average time from index procedure to first retreatment being 7 months. The primary safety outcome was 98% with no device-related major adverse events reported.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>This novel ultrasound imaging and charge density mapping system safely guided ablation of nonpulmonary vein targets in persistent AF patients with 73% single procedure and 93% second procedure freedom from AF at 12 months.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT02825992 EU\/NCT02462980 CN.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.119.007233","type":"journal-article","created":{"date-parts":[[2019,6,27]],"date-time":"2019-06-27T09:00:16Z","timestamp":1561626016000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":96,"title":["Targeting Nonpulmonary Vein Sources in Persistent Atrial Fibrillation Identified by Noncontact Charge Density Mapping"],"prefix":"10.1161","volume":"12","author":[{"given":"Stephan","family":"Willems","sequence":"first","affiliation":[{"name":"University Hospital, Hamburg, Germany (S.W., C.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul","family":"Verma","sequence":"additional","affiliation":[{"name":"Southlake Regional Health Centre, University of Toronto, Newmarket, Ontario, Canada (A.V., P.M.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy R.","family":"Betts","sequence":"additional","affiliation":[{"name":"Oxford Biomedical Research Centre (T.R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Murray","sequence":"additional","affiliation":[{"name":"Freeman Hospital, Newcastle Upon Tyne, United Kingdom (S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petr","family":"Neuzil","sequence":"additional","affiliation":[{"name":"Na Homolce Hospital, Prague, Czech Republic (P.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00fcseyin","family":"Ince","sequence":"additional","affiliation":[{"name":"University Hospital Rostock, Berlin (H.I.)."},{"name":"Vivantes Klinikum, Berlin (H.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Steven","sequence":"additional","affiliation":[{"name":"University Hospital Cologne, Germany (D.S., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arian","family":"Sultan","sequence":"additional","affiliation":[{"name":"University Hospital Cologne, Germany (D.S., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick M.","family":"Heck","sequence":"additional","affiliation":[{"name":"Southlake Regional Health Centre, University of Toronto, Newmarket, Ontario, Canada (A.V., P.M.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark C.","family":"Hall","sequence":"additional","affiliation":[{"name":"Liverpool Heart and Chest Hospital, United Kingdom (M.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Tondo","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, Milan, Italy (C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Pison","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Center, the Netherlands (L.P.)."},{"name":"Zienkenhuis Oost Limburg, Belgium (L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Wong","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital and Harefield NHS Foundation Trust, London, United Kingdom (T.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas V.","family":"Boersma","sequence":"additional","affiliation":[{"name":"St. Antonius Hospital, Nieuwegein, the Netherlands (L.V.B.)."},{"name":"Amsterdam University Medical Center, the Netherlands (L.V.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Meyer","sequence":"additional","affiliation":[{"name":"University Hospital, Hamburg, Germany (S.W., C.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Grace","sequence":"additional","affiliation":[{"name":"Royal Papworth Hospital Foundation Trust, Cambridge (A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005119"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31072-3"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.05.012"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw210"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000040"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.064"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-041316-090015"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.026054"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.09.088"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux297"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.310489"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.126422"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13132"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602014"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.2029"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2013.04.015"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2015.04.010"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2017.08.012"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-16-1334"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408288"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.10.010"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.10.038"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.010256"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.05.022"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.117.006022"},{"key":"e_1_3_4_27_2","first-page":"S531","article-title":"Mapping stability with ultrasound-based imaging and dipole density mapping in patients with persistent atrial fibrillation [abstract].","volume":"14","author":"Nuhrich J","year":"2017","unstructured":"Nuhrich, J, Moser, J, Schaffer, B, Akbulak, RO, Eickholt, C, Kuklik, P, Meyer, C, Willems, S. Mapping stability with ultrasound-based imaging and dipole density mapping in patients with persistent atrial fibrillation [abstract]. Heart Rhythm. 2017;14:S531.","journal-title":"Heart Rhythm"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61462-7"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30968-0"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707855"}],"container-title":["Circulation: Arrhythmia and Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCEP.119.007233","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:02:17Z","timestamp":1715558537000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCEP.119.007233"}},"subtitle":["UNCOVER AF Trial"],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":29,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1161\/CIRCEP.119.007233"],"URL":"https:\/\/doi.org\/10.1161\/circep.119.007233","relation":{},"ISSN":["1941-3149","1941-3084"],"issn-type":[{"value":"1941-3149","type":"print"},{"value":"1941-3084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7]]},"assertion":[{"value":"2019-01-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e007233"}}