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. 2019 Aug 29;125(6):609–627. doi: 10.1161/CIRCRESAHA.119.314930

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© 2019 The Authors.

Circulation Research is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.

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Figure 6. — Leading-driver regions are highly stable intraprocedure. A, Example of persistent atrial fibrillation (AF) termination after ablating the coronary sinus region delineated with a fuchsia dashed line for 11.4 min. Then, AF was reinduced and lasted >10 min. After 11 additional minutes of radiofrequency delivery (orange dashed line), AF terminated again and was no longer sustainable. B, Case with extensive atrial remodeling due to severe tricuspid regurgitation. Much higher median values of instantaneous frequency modulation (iFM_median) than in the rest of animals were documented over large areas of the left atrium. AF did not terminate despite 97 min of radiofrequency delivery. However, ablation resulted in an important reduction in the overall atrial activation rate measured by dominant frequency (DF) from the 12-lead surface ECG (bottom panel), which indicated that ablation effectively modified the AF substrate. *The locations where the displayed signals were retrieved from. iAM indicates instantaneous amplitude modulation; and iFM, instantaneous frequency modulation.