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Peer-reviewedCC BYFrontiers in network physiology

Open wavefront ablation terminates rotor-driven atrial fibrillation.

  • Arthur S Bezerra1
  • Robin Van Den Abeele1
  • Bram Van Landeghem1
  • Bjorn Verstraeten1
  • Sebastiaan Lootens1
  • Viktor Van Nieuwenhuize1
  • Sander Hendrickx1
  • Vincent F M Segers2
  • Mattias Duytschaever3
  • Nele Vandersickel1
  1. 1Department of Physics and Astronomy, Ghent University, Ghent, Belgium.
  2. 2Department of Pharmaceutical Sciences, Antwerp University, Antwerp, Belgium.
  3. 3AZ Sint-Jan, Cardiology Department, Bruges, Belgium.
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Abstract

Introduction

Atrial arrhythmias, notably atrial fibrillation (AF), exhibit complex spatiotemporal patterns that remain incompletely characterized. Based on topological constraints requiring counter-rotating reentries in two-dimensional manifolds, we present a framework classifying all atrial wavefronts into two fundamental archetypes: open and closed waves. Open waves are line-like structures bounded by endpoints that tend to self-perpetuate; closed waves are ring-like structures lacking endpoints that tend toward self-termination.Methods and results

We demonstrate that complex wavefront interactions reduce to five elementary processes: (1) Open wave creation, (2) Open wave annihilation, (3) Closed wave creation, (4) Closed wave annihilation and (5) Open wave collision. Validation within a cohort of 600 patient-specific AF simulations showed that all observed events adhered to these constructed topological rules, suggesting that complexity of fibrillatory conduction within the studied computational framework arises from simple underlying principles. Furthermore, closing all open waves, achieved a 100% success rate when electrical silence was used as the primary criteria for efficacy.Discussion

This unified framework reconciles existing electrophysiological theories, including the multiple wavelet hypothesis, the mother rotor hypothesis, meandering rotors, and focal sources, while providing a foundation for optimizing clinical interventions.

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Cite

BibTeXRIS
BibTeX
@article{bezerra2026open,
  title = {{Open wavefront ablation terminates rotor-driven atrial fibrillation.}},
  author = {Arthur S Bezerra and Robin Van Den Abeele and Bram Van Landeghem and Bjorn Verstraeten and Sebastiaan Lootens and Viktor Van Nieuwenhuize and Sander Hendrickx and Vincent F M Segers and Mattias Duytschaever and Nele Vandersickel},
  journal = {Frontiers in network physiology},
  year = {2026},
  month = oct,
  doi = {10.3389/fnetp.2026.1940428},
  url = {https://europepmc.org/article/MED/42923143},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Open wavefront ablation terminates rotor-driven atrial fibrillation.
AU  - Arthur S Bezerra
AU  - Robin Van Den Abeele
AU  - Bram Van Landeghem
AU  - Bjorn Verstraeten
AU  - Sebastiaan Lootens
AU  - Viktor Van Nieuwenhuize
AU  - Sander Hendrickx
AU  - Vincent F M Segers
AU  - Mattias Duytschaever
AU  - Nele Vandersickel
PY  - 2026
DA  - 2026/10/08
JO  - Frontiers in network physiology
DO  - 10.3389/fnetp.2026.1940428
UR  - https://europepmc.org/article/MED/42923143
AB  - Introduction  Atrial arrhythmias, notably atrial fibrillation (AF), exhibit complex spatiotemporal patterns that remain incompletely characterized. Based on topological constraints requiring counter-rotating reentries in two-dimensional manifolds, we present a framework classifying all atrial wavefronts into two fundamental archetypes: open and closed waves. Open waves are line-like structures bounded by endpoints that tend to self-perpetuate; closed waves are ring-like structures lacking endpoints that tend toward self-termination.Methods and results  We demonstrate that complex wavefront interactions reduce to five elementary processes: (1) Open wave creation, (2) Open wave annihilation, (3) Closed wave creation, (4) Closed wave annihilation and (5) Open wave collision. Validation within a cohort of 600 patient-specific AF simulations showed that all observed events adhered to these constructed topological rules, suggesting that complexity of fibrillatory conduction within the studied computational framework arises from simple underlying principles. Furthermore, closing all open waves, achieved a 100% success rate when electrical silence was used as the primary criteria for efficacy.Discussion  This unified framework reconciles existing electrophysiological theories, including the multiple wavelet hypothesis, the mother rotor hypothesis, meandering rotors, and focal sources, while providing a foundation for optimizing clinical interventions.
SN  - 2674-0109
ER  -