{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T18:06:52Z","timestamp":1784657212133,"version":"3.55.0"},"reference-count":42,"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":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Conventional activation mapping of atrial fibrillation (AF) during clinical procedures is limited by low-amplitude, fractionated electrograms and cycle length variability. The Tau20-RETROmapping stimulator-recorder system (TauRhythm Therapies, United Kingdom) is an investigational device used to identify nonpulmonary vein AF drivers by real-time, high-density activation mapping of uniform wavefronts during AF. We validated the accuracy of the system and applied it to left atrial mapping for evidence of AF drivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Left atrial geometry was acquired using a 3-dimensional electroanatomic mapping system with high-density mapping catheters (CARTO 3 with Optrell, or EnSite X with HD Grid). Electrograms were recorded for 30 seconds at multiple left atrial sites. The Tau20-RETROmapping system generates activation maps of organized wavefronts. System performance was manually validated against randomly sampled local electrograms using a grid sweep of thresholds to identify Pareto-optimal parameters in sinus rhythm, atrial pacing, atrial tachycardia (AT), and AF. The system was then applied to identify putative driver activation patterns during persistent AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>We studied 24 patients undergoing pulmonary vein isolation for AF. Six patients presented in sinus rhythm or AT, in whom the system demonstrated a sensitivity of 100.0% (95% CI, 80.5%\u2013100.0%) and a specificity of 100.0% (85.2%\u2013100.0%). Eighteen patients were mapped in AF: the system had a sensitivity of 94.4% (86.2%\u201398.4%) and a specificity of 97.1% (89.9%\u201399.6%) when identifying organized AF wavefronts, and accurately identified the earliest activation in 89.6% (79.7%\u201395.7%) of waves. Stable propagation originating from the left atrial appendage (LAA) was observed in 3\/18 patients, while 8\/18 demonstrated competing propagation toward and away from the LAA. Conduction away from the LAA was detected along the anterior (8\/18 patients), lateral (8\/18 patients), and posterior (7\/18 patients) walls. No propagation near the LAA was observed in 6\/18 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The Tau20-RETROmapping system enables real-time activation mapping of AF, with the most convincing driver-like areas being identified around the LAA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.126.015039","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T09:02:23Z","timestamp":1782982943000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Tau20-RETROmapping System Identifies Driver-Like Activation Patterns in Real Time During Persistent Atrial Fibrillation"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7229-9526","authenticated-orcid":true,"given":"Oliver 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