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Related Experiment Video

Updated: Jun 21, 2026

High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation
09:17

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Published on: July 29, 2011

Focal Activations Detected by an Automated Mapping System: Insights From Contralateral Atrial Burst Pacing.

Hirotake Yokoyama1, Susumu Takase1, Yasushi Mukai2

  • 1Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan.

Pacing and Clinical Electrophysiology : PACE
|June 20, 2026
PubMed
Summary

CARTO FINDER system performance for detecting focal activations (FAs) in atrial fibrillation (AF) needs refinement. Many detected FAs may stem from complex pathways, not just focal sources, impacting diagnostic accuracy.

Keywords:
FINDERatrial fibrillationautomated mapping systemfocal activation

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Published on: February 22, 2018

Area of Science:

  • Electrophysiology
  • Cardiac Mapping
  • Atrial Fibrillation Pathophysiology

Background:

  • The diagnostic accuracy of the CARTO FINDER system for identifying repetitive focal activations (FAs) that may drive atrial fibrillation (AF) is currently debated.
  • Understanding the origin and nature of these FAs is crucial for improving AF management.

Purpose of the Study:

  • To evaluate the features and potential mechanisms of FAs detected by a mapping system during contralateral atrial burst pacing (CLABP) in sinus rhythm (SR) and during AF.
  • To assess the overlap and characteristics of FAs detected under different pacing and rhythm conditions.

Main Methods:

  • A prospective single-center study involving sequential mapping of the atria during CLABP in SR (Protocol 1) and during AF (Protocol 2).
  • In Protocol 2, FAs were remapped during CLABP after SR restoration to evaluate overlap.
  • Comparison of mean cycle length (mCL) and its standard deviation (CL-Std) between overlapping and non-overlapping FA sites during AF.

Main Results:

  • FAs were detected in various regions of both atria, with high detection rates in the left atrial appendage (LAA)/right atrial appendage (RAA), septal regions, and posterior/inferior left atrium during both CLABP and AF.
  • Overlapping FA sites during CLABP and AF exhibited longer mCL and higher CL-Std compared to non-overlapping sites.
  • However, neither mCL nor CL-Std reliably predicted site overlap.

Conclusions:

  • A significant proportion of FAs identified by the CARTO FINDER system may originate from complex activation patterns rather than simple focal sources.
  • These findings highlight existing interpretive challenges and suggest areas for future refinement of cardiac mapping systems and analysis techniques.