Identification of regions maintaining atrial fibrillation through cycle length and cycle length gradient mapping

Background Visualizing the specific regions where atrial fibrillation (AF) is maintained is crucial for effective treatment, but it remains challenging in clinical practice. We aimed to address this challenge by developing a mapping approach focused on the cycle length (CL) and its gradient (CL‐gradient). Methods In 105 patients undergoing initial ablation for persistent AF, pre‐ablation CARTOFINDER data were utilized to create maps based on three indicators: (1) CL, the atrial frequency during AF calculated using CARTOFINDER; (2) Short CL, encompassing CLs within 5 ms of the minimum CL; and (3) CL‐gradient, the CL range within a 6 mm radius. We evaluated the association between the AF termination through ablation and the measured values and patterns in each map. Results AF termination occurred in 17 patients. The AF termination group exhibited the significant large maximum CL‐gradient (48.8 ms [interquartile range, 38.6–66.3], p