{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:34:01Z","timestamp":1791225241809,"version":"4.1.0"},"reference-count":39,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T00:00:00Z","timestamp":1664496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Heart, Lung, and Blood Institute","award":["R01 HL146463"],"award-info":[{"award-number":["R01 HL146463"]}]},{"name":"National Heart, Lung, and Blood Institute","award":["SPN00658"],"award-info":[{"award-number":["SPN00658"]}]},{"DOI":"10.13039\/100001297","name":"Elisabeth Severance Prentiss Foundation","doi-asserted-by":"publisher","award":["R01 HL146463"],"award-info":[{"award-number":["R01 HL146463"]}],"id":[{"id":"10.13039\/100001297","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001297","name":"Elisabeth Severance Prentiss Foundation","doi-asserted-by":"publisher","award":["SPN00658"],"award-info":[{"award-number":["SPN00658"]}],"id":[{"id":"10.13039\/100001297","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Phase analysis has been used to identify and localize atrial fibrillation (AF) sources for targeted ablation. We previously demonstrated that repetitive wannabe reentry (incomplete reentry) often generated an apparent stable rotor using phase analysis. The misinterpretation caused by phase analysis using atrial electrograms (AEGs) may result from detecting inaccurate time points at phase inversion (\u03c0 to \u2212\u03c0) in the instantaneous phase waveform converted from AEG. The purpose of this study was to evaluate the accuracy of phase analysis to detect atrial activations recorded from the high-density mapping of AF in patients with persistent and long-standing persistent (LSP) AF. Methods and Results: During open heart surgery, we recorded activation from both atria simultaneously using 512 electrodes in 7 patients with persistent and LSP AF. The phase analysis was compared to manual measurements during 4 s of data. For the accuracy of activation sequence maps, a successful recording site was defined as having \u22644 mismatched activation times during the 4 s. In all AF episodes, the accuracy of the phase analysis was only 82% of the total number of activation times due to either activation time differences (14.7%), under-sensing (2.7%), or over-sensing (0.6%). Only 67.9% of the total recording sites met the requirement of a successful recording site by phase analysis. In unsuccessful recording sites, AEG characteristics were relatively irregular cycle length (CL), complex AEG, and double potential AEG. Conclusion: The phase analysis was less accurate in recording sites with a relatively irregular CL, complex AEG, or double potential AEG. As a result, phase analysis may lead to the misinterpretation of atrial activation patterns during AF. A visual review of the original AEG is needed to confirm the detected AF sources of phase analysis before performing targeted ablation.<\/jats:p>","DOI":"10.3390\/jcm11195807","type":"journal-article","created":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T23:39:31Z","timestamp":1665272371000},"page":"5807","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["An Evaluation of Phase Analysis to Interpret Atrial Activation Patterns during Persistent Atrial Fibrillation for Targeted Ablation"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0122-1134","authenticated-orcid":false,"given":"Seungyup","family":"Lee","sequence":"first","affiliation":[{"name":"Departments of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA"},{"name":"Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celeen M.","family":"Khrestian","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayakumar","family":"Sahadevan","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert L.","family":"Waldo","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA"},{"name":"Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1161\/CIRCULATIONAHA.113.005421","article-title":"Driver domains in persistent atrial fibrillation","volume":"130","author":"Haissaguerre","year":"2014","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.jacc.2013.03.021","article-title":"Direct or coincidental elimination of stable rotors or focal sources may explain successful atrial fibrillation ablation: On-treatment analysis of the CONFIRM trial (Conventional ablation for AF with or without focal impulse and rotor modulation)","volume":"62","author":"Narayan","year":"2013","journal-title":"J. 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