Let’s get down to the nitty-gritty in persistent atrial fibrillation: the continuous critical mass of the atria—Authors’ reply
Bibliographic record
Abstract
Let's get down to the nitty-gritty in persistent atrial fibrillation: the continuous critical mass of the atria I should like to express my hearty congratulations to the authors for this interesting article by Sau et al. 1 They conclude that linear ablation, posterior wall isolation, complex fractionated atrial electrogram ablation improves intraprocedural atrial fibrillation (AF) termination.Moreover, left atrial (LA) size directly affects final outcome for AF ablation, by dropping down at a rate of 4% for every 1 mm increase in diameter for freedom from AF. 1 Nevertheless, I should like to draw attention to the nitty-gritty.At first glance, we must be clear in our own minds that long-standing persistent AF depends on self-sustaining based upon the macroreentrant circuits, also called drivers, rotors, or mother-rotors.They are located anywhere in both atria, but not exclusively into pulmonary veins or left atrial appendage. 2 In this context, the more integrative the strategy, the better outcome for AF ablation.The key point is to know that the minimum size for the rotor to get AF is 6 cm in diameter or larger than this in human atria. 3 However, far beyond expectation, it has become evident that the 'atrial critical mass' is one of the finest points here.Thus, a non-focal approach in 'one-go' or 'one single step' (such as the maze procedure) seems to be the best option as a specific strategy to approach AF, because we are facing on, settling all possible causes on both atria at the same time. 4 What it is really important here is to highlight that beyond the LA size, what really matters is the continuous critical mass of the LA.LA size has nothing whatsoever to do as long as all possible rotors are divided at the same time by means of additional lines or another more complete approach as maze procedure.A full bi-atrial lesion pattern is the best option to eliminate AF in cases of persistent AF. 4 Hence, working in this framework with a more integrative ablative strategy, best long-lasting results are achieved with the true maze procedure, up to 90% for success of freedom from AF.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".