What does this research mean for the field?

Non-invasive driver stability mapping identified stable AF drivers in 88.9% of patients where ablation resulted in AF termination. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

The aim was to examine if stable AF drivers identified via non-invasive mapping correlate with ablation sites for AF termination.

February 8, 2026European Heart Journal

Non-invasive driver stability mapping predicts ablation sites of atrial fibrillation termination

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Key result

Non-invasive driver stability mapping predicts persistent AF termination ablation sites with ~89% accuracy.

Why the study?

Success rates of AF ablation remain unsatisfactory and current invasive mapping systems lack comprehensive assessment of spatio-temporal AF patterns to identify potential driver ablation targets.

Does non-invasive driver stability mapping predict ablation sites of atrial fibrillation termination in patients undergoing AF ablation?

Population

90 consecutive AF-ablation patients presenting in AF

Comparison

Peri- and intraprocedural non-invasive mapping of AF drivers versus ablation sites causing termination

Design

Substudy of a multicenter trial

Authors

TAT F AlthoffUniversitat de Barcelona ILInés Llorente-LipeAdif (Spain)IHI Hernandez-Romero

Discussion

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Implication

May identify ablation targets noninvasively in persistent AF; hypothesis-generating pending prospective validation.

Key Points

The aim was to examine if stable AF drivers identified via non-invasive mapping correlate with ablation sites for AF termination.
Conducted non-invasive mapping during atrial fibrillation ablation in patients.
Recorded ECGi-maps of local AF cycle lengths repeatedly during the procedure.
Defined stable AF drivers based on AF cycle lengths and recording time.
Performed targeted regional ablations and analyzed their relation to stable drivers.
In 18 out of 90 patients, ablation led to AF termination.
Stable drivers were found in 16 of these patients in the 'termination region'.
On average, 2.8 stable drivers were present across predefined atrial regions.
Detected drivers in termination regions had a mean cycle length of 149 ms.

Structured PICO

Does non-invasive driver stability mapping predict ablation sites of atrial fibrillation termination in patients undergoing AF ablation?

Population

90 consecutive AF-ablation patients presenting in atrial fibrillation

Intervention

Peri- and intraprocedural non-invasive driver stability mapping (ECGi) to identify stable AF drivers

Outcome

Presence of a stable driver in the region where ablation resulted in AF terminationsurrogate

Non-invasive driver stability mapping accurately identifies AF drivers and predicts sites where ablation leads to AF termination, suggesting potential for personalized ablation strategies.

Cite This Study

Althoff et al. (2025) studied this question. Non-invasive driver stability mapping predicted AF termination ablation sites with 89% accuracy in 18 patients during persistent AF ablation.

synapsesocial.com/papers/698828850fc35cd7a884821c https://doi.org/10.1093/eurheartj/ehaf784.829

Topics

Pulsed Field Ablation Persistent AF management Atrial fibrillation AF ablation outcomes Anticoagulation in AF

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Non-invasive driver stability mapping predicts ablation sites of atrial fibrillation termination

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Non-invasive driver stability mapping predicts ablation sites of atrial fibrillation termination

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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