Arrhythmias & electrophysiologyResearch article
Virtual Heart–Based Prediction of Ablation Outcomes in Persistent Atrial Fibrillation Based on Non–Pulmonary Vein Drivers
- analysis of left atrial virtual heart models
- integrating cardiac computed tomography and electroanatomical maps
- from the CUVIA-AF2 study
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
- Stable PS with stable DFn = 43
- Stable PS with meandering DFn = 81
Main finding
As reported in the abstract
Stable PS at extra-pulmonary vein regions
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
| Comparison | adjusted hazard ratio (95% CI) | P value | |
|---|---|---|---|
| Stable PS with stable DF · higher 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 | Estimate | 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:10.1161/circep.125.014266
Summarised from the published abstract; every number is checked against it