{"doi":"10.1111/jce.16365","title":"Authors' response to letter to the editor regarding impact of artificial intelligence arrhythmia mapping on time to first ablation, procedure duration, and fluoroscopy use","abstract":"Authors' Reply We appreciate the insightful comments by Mr. Guerini and colleagues regarding the study of impact of artificial intelligence (AI) on time to first ablation, total procedural duration, and fluoroscopy use.1 Regarding the retrospective nature of the study, we agree that this study design may include unaccounted-for differences between the study patients and controls. However, given the novelty of the studied technology, the retrospective study design provided an early assessment of the clinical impact of AI on procedure metrics and a preliminary quantification of the magnitude of the clinical benefits to help plan future prospective studies. We also agree with concerns regarding the use of historical controls. Such limitations include the inclusion of additional confounding variables unaccounted for by the matching and correction processes. Importantly, the study performed a detailed assessment of the mapping and ablation technologies used for study patients and controls. Except for panoramic mapping catheters in the AF subgroup, mapping and ablation technologies were not different between study and control arms. Furthermore, the magnitudes of benefits were consistent between analyzed arrhythmia types. Although the present study did not provide details regarding the mapping algorithm, such information has been published in prior work.2 In the Supplemental Material for the prior manuscript, detailed descriptions of the algorithm, computational models, and validation processes were described in detail. Such information provides reassurances regarding the successful implementation of AI technology. Finally, we agree that the results of this study may not be generalizable across all clinical settings for different patient populations, procedural techniques, and operator expertise. However, the study does provide insights regarding which clinical practices may benefit more than others. From the results of the research, patient populations with greater proportions of persistent and recurrent atrial fibrillation and complex ventricular tachycardia cases would be expected to benefit to a greater degree as both the AF and VT subgroups had statistically significant reductions in procedure time for study patients versus controls. Regarding procedural techniques, it may also be inferred from the present study that physicians who modified their workflows towards a paradigm in which focused geometry creation and mapping based upon the output of the AI mapping algorithm may realize greater benefit than routine bi-atrial or bi-ventricular geometry creation and mapping. Physicians of all levels of experience levels who adjusted their procedural workflows demonstrated improved procedural efficiencies with this focused approach. In conclusion, we appreciate the insightful comments from Mr. Guerini and co-authors. We agree that this study is an important step towards routine integration of AI into clinical procedural practice. We further agree that prospective, randomized controlled trials are essential to validate these findings; such studies are presently in planning or underway based, in part, upon the results of the present work. Dr. Krummen has received grant support from the American Heart Association (10 BGIA 3500045), UCSD Galvanizing Engineering in Medicine (GEM) Grant, University of California Center for Accelerated Innovation Grant, and a UCSD Rady Meet Grant relevant to this study. Dr. Ho has received grant funding from the American Heart Association (AHA 19CDA34760021) and the National Institutes of Health (NIH 1KL2TR001444) relevant to this study. Dr. McCulloch is supported by grants from the NIH (HL131753, HL121754) and AHA (AWS 4.0 DGP) and the Saving Tiny Hearts Society. Dr. Fox, Mr. Toomu, Dr. Gu, Ms. Kang, Dr. Sung, and Dr. Raissi report no conflict of interest. Dr. Krummen, Dr. Ho, and Dr. McCulloch report equity in Vektor Medical and intellectual property, assigned to UCSD. Dr. Han, Dr. Hoffmayer, and Dr. Feld re","journal":"Journal of Cardiovascular Electrophysiology","year":2024,"id":500645,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9581,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":283466,"name":"Avinash Toomu","orcid":null,"position":1,"is_corresponding":false},{"id":753061,"name":"Kelly Gu","orcid":null,"position":2,"is_corresponding":false},{"id":539910,"name":"Jessica Kang","orcid":null,"position":3,"is_corresponding":false},{"id":1219377,"name":"Kevin Sung","orcid":"0000-0002-8513-6956","position":4,"is_corresponding":false},{"id":694967,"name":"Frederick T. Han","orcid":"0000-0003-3195-6032","position":5,"is_corresponding":false},{"id":694969,"name":"Kurt S. Hoffmayer","orcid":"0000-0003-0002-2368","position":6,"is_corresponding":false},{"id":694968,"name":"Jonathan C. Hsu","orcid":"0000-0002-1523-573X","position":7,"is_corresponding":false},{"id":694970,"name":"Farshad Raissi","orcid":"0000-0002-7663-4347","position":8,"is_corresponding":false},{"id":694973,"name":"Gregory K. Feld","orcid":"0000-0002-3099-2982","position":9,"is_corresponding":false},{"id":262489,"name":"Andrew D. McCulloch","orcid":"0000-0002-1708-5675","position":10,"is_corresponding":false},{"id":447838,"name":"Gordon Ho","orcid":"0000-0001-6467-3333","position":11,"is_corresponding":false},{"id":328093,"name":"David E. Krummen","orcid":"0000-0003-3123-8970","position":12,"is_corresponding":false},{"id":1219967,"name":"Sutton R. Fox","orcid":null,"position":0,"is_corresponding":true}],"reference_count":2,"raw_metadata":null,"created_at":"2026-07-19T02:10:08.435215Z","pmid":"38979951","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}