Arrhythmias & electrophysiology
Virtual Heart–Based Prediction of Ablation Outcomes in Persistent Atrial Fibrillation Based on Non–Pulmonary Vein Drivers
Authors' conclusion
Stable PS with stable DF identified in virtual heart models was associated with adverse model-derived regional substrate features and higher recurrence rates after ablation. Virtual heart-based identification of these markers may improve prediction of ablation response in persistent AF, warranting prospective validation.
Study context
- Population
- Patients with persistent atrial fibrillation (AF) from the CUVIA-AF2 studypatients with persistent AF
- Participants
- 165 patients
- Comparison
- Stable PS with stable dominant frequency (DF) vs stable PS with meandering DF at extra-pulmonary vein regions
- Stable PS with stable DFn = 43
- Stable PS with meandering DFn = 81
- Outcome
- Stable PS at extra-pulmonary vein regions
Methodological detailsintegrating cardiac computed tomography and electroanatomical maps, from the CUVIA-AF2 study
- Integrating cardiac computed tomography and electroanatomical maps
- From the CUVIA-AF2 study
Main finding
As reported in the abstract
Stable PS at extra-pulmonary vein regions observed
124 (75%) patients
Of these, stable DF
43
34.7%
Of these, meandering DF
81
65.3%
Further findings
AF recurrence · 1-year follow-up
| Adjusted hazard ratio (95% CI) | P value | ||
|---|---|---|---|
| Stable PS with stable DFHigher AF recurrence with stable PS with stable DF | 5.78 (2.18–15.3) | log-rank P =0.002 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
| Outcome | Stable PS with stable DF | Stable PS with meandering DF | P value |
|---|---|---|---|
| Maximal slope of the action potential duration restitution curve (regional analysis)Higher with stable PS with stable DF | 1.41±0.80 | 1.09±0.60 | P < 0.001 |
| Local virtual low-voltage burden | 2.96±3.23% | 2.10±2.75% |
Recurrence prediction by model including stable PS and DF
- Apparent area under the curve
- 0.765
Original publication
Virtual Heart–Based Prediction of Ablation Outcomes in Persistent Atrial Fibrillation Based on Non–Pulmonary Vein Drivers. Circ Arrhythm Electrophysiol. Published 25 September 2026. doi:10.
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