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[362, 764, 1080, 1337], 'disorganized': [364, 841], 'myocyte': [365], 'protein': [366, 394], 'apparatus': [367], 'resultant': [369, 802], 'interstitium,': [372], 'nonfibrotic': [374], 'nidus': [375], 'gadolinium': [377, 542, 655, 811, 1636], 'accumulation.': [378], 'may': [380, 549, 662, 763, 771, 808, 1298, 1336], 'also': [381], 'result': [382, 809], 'noncollagenous': [384], 'interstitium': [388], 'infiltration': [391], '(amyloidosis),': [395], 'granulomatous': [396], 'deposits': [397], '(sarcoidosis),': [398], 'inflammation': [401], '(myocarditis).': [402], 'These': [403], 'subtypes': [404], 'NICM,': [406, 421, 478, 1199], 'however,': [407, 1166], 'only': [408, 1387, 1817], 'represent': [409], 'minority': [411], 'cases.': [413], 'up': [415], 'half': [417], 'can': [423, 445], 'seen': [425], 'midmyocardium': [428, 939], '(Figure),': [429], 'cause': [432], 'histopathologic': [434], 'composition': [435, 1406], 'have': [439, 686, 709, 779, 1122], 'not': [440, 942, 1022, 1299, 1492, 1764, 1783, 1796, 1803], 'been': [441, 853], 'established.': [442], 'T1': [443], 'mapping': [444, 1254, 1378], 'measure': [446], 'burden': [448], 'global': [450], 'diffuse': [451], 'fibrosis,': [452], 'current': [454, 1281], 'clinical': [455, 1067], 'sequences': [457], 'lack': [458], 'spatial': [460, 908, 1074], 'resolution': [461, 576], 'visualize': [463], 'regional': [464], 'variations': [465], 'interstitial': [467], 'fibrosis.': [468], 'Given': [469], 'uncertainty': [471], 'underlying': [474, 1163, 1296], 'pathophysiology': [475, 1358], 'idiopathic': [477, 1362], 'we': [479, 1367], 'must': [480], 'consider': [481], 'another': [482], 'hypothesis': [483, 1063], 'mechanism': [486, 1162, 1177, 1600], 'LGE,': [488, 1019, 1151], 'based': [489, 1375, 1386], 'upon': [490, 1376], 'anatomic': [492], 'orientation': [493, 912, 934, 950, 1072, 1272, 1439], 'mechanical': [495, 1323], 'interaction': [496, 1045], 'fiber': [499, 911, 933, 949, 1071, 1271], 'layers.Download': [500], 'figureDownload': [501], 'PowerPointFigure.': [502], 'ventricular': [504, 673, 703, 799, 826, 1115, 1146, 1180, 1285], 'consists': [506, 675], 'three': [508, 677], 'layers': [509, 584, 678, 917, 1040, 1318], 'differentially': [511, 680], 'oriented': [512, 681], 'fibers.': [513, 682], 'systole,': [515, 626, 723], 'shear': [517, 628, 725, 1275, 1324, 1593], 'forces': [518, 629, 726], 'develop': [519, 630, 727, 1114], "sheet's": [523, 634], 'cleavage': [524, 635, 732, 1596], 'planes': [525, 636, 1597], 'orientations.': [528], 'strain': [530, 643, 757], 'created': [531, 644, 758], 'these': [533, 646, 760, 973, 1014, 1120, 1334], 'fibers': [534, 647, 685, 708, 715, 761, 835], 'separate': [535, 648, 762], 'space': [540, 653, 786, 807, 1267], 'accumulation': [543, 656], 'midmyocardium.': [546, 659, 816], 'This': [547, 660, 740, 769, 1870], 'process': [548, 661, 770], 'exaggerated': [551, 664, 773], 'non-ischemic': [555], 'cardiomyopathy).': [556, 669], 'A,': [557, 1553, 1698, 1706], 'Short-axis': [558, 602], 'slice': [559], 'normal': [561, 1602], 'porcine': [562], '(left)': [563], 'human': [565, 896, 1679], '(right)': [566], 'hearts': [567], 'diffusion-tensor': [569, 900, 1441], 'cardiac': [570, 1327, 1442, 1639], 'submillimeter': [575, 1684], 'showing': [577, 612], 'myofiber': [579, 698, 790, 892, 916, 1277, 1317, 1438], 'orientations': [580, 639, 925, 1321], 'endocardium': [586], 'epicardium': [588], '(color-coded': [589], 'by': [590, 1053, 1302, 1310, 1683, 1733], 'absolute': [592], 'values': [593], 'inclination': [596, 694], 'angle': [597, 690, 695], '0°–65°).': [598], 'B': [599], 'C,': [601, 1541], 'patient': [607], 'dilated': [609], 'linear,': [613], 'mid-wall': [614], '(LGE)': [617], 'septum,': [620], 'inferior': [621, 965], 'inferolateral': [623], 'walls.': [624], '(dashed': [640], 'lines).': [641], 'Created': [670], 'BioRender.com.The': [672], 'Quantitatively,': [683], 'subendocardial': [684, 736], 'positive': [688], 'helix': [689, 712], '(defined': [691], 'relative': [699], 'left': [702, 798, 857, 1632, 1729], 'short-axis': [704, 720], 'plane),': [705], 'whereas': [706], 'subepicardial': [707], 'negative': [711], 'angle.1': [713], 'Midmyocardial': [714], 'circumferential': [717, 990], 'plane.': [721], 'During': [722], 'sheets': [731], 'planes,': [733], 'particularly': [734, 813], 'between': [735, 875, 1276, 1316], 'midmyocardial': [738], 'layers.2': [739], 'extension': [743], 'radial': [745], 'reorientation': [746, 791], 'myofibers,': [748], 'facilitating': [749], 'thickening': [751], 'ejection': [753], 'blood.': [755], 'who': [778, 1113], 'ongoing': [780], 'collagenous': [781], 'well': [788], 'remodeling': [794], 'response': [796], 'dilatation.': [800], 'accumulation,': [812], 'Another': [817], 'example': [818], 'phenomenon': [821], 'at': [823, 937, 954, 963, 1333, 1417], 'right': [825], 'septal': [827], 'insertion': [828], 'sites': [829, 1141, 1335], 'where': [830], 'intersection': [832, 977], 'both': [837], 'ventricles': [838], 'architecture,': [843], 'space,': [848], 'LGE.Moreover,': [850], 'reported': [854], 'atria': [858, 897, 1005, 1680], '(LA)': [859], 'without': [862, 1010], 'prior': [863], 'history': [864], 'ablation.': [866], 'Importantly,': [867], 'such': [869, 913, 982, 1195], 'cases,': [870], 'there': [871], 'no': [873, 1484, 1810], 'association': [874], 'voltage,': [879, 1025], 'well-established': [881], 'surrogate': [882], 'scar.3': [885], 'Pashakhanloo': [886, 1425, 1659], 'et': [887, 1560, 1715], 'al.': [888, 1561, 1716], 'derived': [889], '3-dimensional': [891], 'architecture': [893, 1403, 1563, 1676], 'high-resolution': [899, 1634], 'CMR.': [901, 1138], 'study,': [904], 'authors': [906, 1421, 1482], 'showed': [907], 'two': [915], '(epicardial': [918], 'endocardial)': [920], 'distinct': [922, 1039], 'perpendicular': [924], 'run': [926], 'across': [927, 944, 1325], 'atrium.4': [929], 'change': [931], 'takes': [935], 'place': [936], 'homogeneous': [943], 'LA.': [946, 971], 'Heterogeneity': [947], 'was': [951], 'prevalent': [953], 'LA': [956, 995], 'roof,': [957], 'near': [958], 'pulmonary': [960], 'veins,': [961], 'anterior': [967, 994], 'walls': [968], 'Anatomically,': [972], 'areas': [974], 'comprise': [975], 'major': [979], 'bundles': [981, 991], 'Bachmann': [985], 'bundle': [986], 'oblique': [988], 'wall.': [996], 'Interestingly,': [997], 'mirrors': [999], 'atrial': [1011, 1289, 1365, 1633, 1650, 1718, 1730], 'fibrillation.5': [1012], 'Additionally,': [1013], 'regions': [1015], 'de': [1017], 'novo': [1018], 'which': [1020, 1031, 1064], 'do': [1021, 1026], 'display': [1023, 1027], 'low': [1024], 'electrogram': [1029, 1643], 'fractionation,': [1030], 'lends': [1032], 'further': [1033], 'support': [1034], 'varying': [1036], 'conduction': [1037, 1084, 1130, 1314], 'reduced': [1044, 1124], 'expanded': [1048, 1265, 1349], 'interlayer': [1049, 1350], 'spacing': [1050], 'identified': [1052], 'LGE.3Further': [1054], 'multimodal': [1055], 'correlation': [1056, 1395], 'studies': [1057, 1118, 1391], 'needed': [1059], 'explore': [1061], 'important': [1066, 1097], 'implications:': [1068], 'variation': [1075], 'signal': [1077], 'dispersion': [1078], 'could': [1079], 'abrupt': [1082, 1311], 'electrical': [1083, 1129, 1183], 'disturbances': [1085], 'potentially': [1086], 'leading': [1087], 'arrhythmias': [1089], 'absence': [1092], 'scar.Clinical': [1095], 'ImplicationsAn': [1096], 'application': [1098], 'its': [1102, 1860], 'integration': [1103], 'prognostication': [1106], 'management': [1108], 'tachycardia.': [1116], 'Electroanatomic': [1117], 'demonstrated': [1123], 'bipolar': [1125], 'voltage': [1126, 1646], 'properties': [1131, 1251, 1315], 'within': [1132, 1188], 'segments': [1134], 'Moreover,': [1139], 'critical': [1140, 1227], 'maintenance': [1144], 'tachycardia': [1147, 1181, 1286], 'predominantly': [1148], 'colocalize': [1149], 'demonstrating': [1152], 'latter': [1155], 'harbors': [1156], 'arrhythmic': [1157], 'substrate': [1158], 'NICM.': [1160], 'association,': [1165], 'complex': [1169], 'compared': [1172], 'cardiomyopathy.': [1175], 'monomorphic': [1179], 'involves': [1182], 'wavefront': [1184], 'propagation,': [1185], 'termed': [1186], 'reentry,': [1187], 'slowly': [1189], 'conductive': [1190], 'around': [1192, 1304], 'nonconductive': [1193], 'electrophysiologists': [1200, 1237], 'their': [1204], 'ability': [1205], 'appropriately': [1207], 'map': [1208], 'ablate': [1210], 'circuits': [1211], 'typically': [1214], 'smaller': [1215], 'difficult': [1217], 'characterize': [1219], 'sampling': [1222], 'density': [1223], 'limitations': [1224], 'presumed': [1226], 'components': [1228], 'deep': [1229], 'mappable': [1231], 'surfaces': [1232], 'myocardium.': [1235], 'Therefore,': [1236], 'often': [1239], 'required': [1240], 'adopt': [1242], 'empirical': [1244, 1330], 'strategy': [1245], 'ablating': [1246], 'electroanatomic': [1250], 'intracardiac': [1253], 'CMR.If': [1258], 'instead': [1259], 'dense': [1261, 1305], 'scar,': [1262], 'represents': [1264], 'heterogeneous': [1270], 'systolic': [1274, 1603], 'sheets,': [1278], 'then': [1279], 'therapeutic': [1282], 'paradigm': [1283], 'even': [1288], 'fibrillation': [1290], 'should': [1291, 1372, 1752, 1808, 1850], 'questioned.': [1293], 'arrhythmogenicity': [1295], 'caused': [1301], 'reentry': [1303], 'scar': [1306], 'fueled': [1309], 'cycle.': [1328], 'Delivering': [1329], 'ablation': [1331, 1370, 1413], 'energy': [1332], 'unnecessary': [1339], 'necrosis': [1340], 'bystander': [1342], 'myocytes': [1344], 'either': [1346], 'side': [1347], 'matrix.': [1351], 'Until': [1352], 'known': [1355], 'about': [1356], 'fibrillation,': [1366, 1719], 'believe': [1368], 'lesions': [1371], 'targeted': [1374], 'electrophysiological': [1377], 'entrainment': [1380], 'maneuvers': [1381], 'when': [1382], 'possible,': [1383], 'MRI': [1389], 'findings.Additional': [1390], 'delineate': [1393], 'necessary': [1408], 'before': [1409], 'ever': [1410], 'destructive': [1412], 'tools': [1414], 'directed': [1416, 1852], 'myocardium.Article': [1419], 'InformationAcknowledgmentsThe': [1420], 'thank': [1422], 'Dr': [1423, 1454, 1472], 'Farhad': [1424], 'his': [1427, 1434], 'contribution': [1429], 'article': [1432, 1490, 1756, 1829], 'through': [1433], 'work': [1435], 'material': [1448], 'figure.Sources': [1451], 'FundingNone.Disclosures': [1453], 'disclosed': [1457], 'grants': [1458], 'Biosense': [1460], 'Webster,': [1461], 'ImriCor,': [1462], 'ADAS': [1463], 'software,': [1464], 'U.S.': [1467], 'National': [1468], 'Institutes': [1469], 'Health;': [1471], 'consultant': [1476], 'Circle': [1478], 'Software.': [1479], 'other': [1481], 'report': [1483], 'conflicts.FootnotesThe': [1485], 'opinions': [1486], 'expressed': [1487], 'necessarily': [1493], 'those': [1494], 'editors': [1497], 'American': [1501, 1909], 'Heart': [1502, 1910], 'Association.For': [1503], 'Sources': [1504], 'Funding': [1506], 'Disclosures,': [1508], 'see': [1509], 'page': [1510], '485.Correspondence': [1511], '[email protected].': [1539], 'Mekkaoui': [1540], 'Huang': [1542], 'S,': [1543, 1627, 1666], 'Chen': [1544], 'HH,': [1545], 'Dai': [1546], 'G,': [1547], 'Reese': [1548], 'TG,': [1549], 'Kostis': [1550], 'WJ,': [1551], 'Thiagalingam': [1552], 'Maurovich-Horvat': [1554], 'P,': [1555, 1619], 'Ruskin': [1556], 'JN,': [1557], 'Hoffmann': [1558], 'U,': [1559], 'Fiber': [1562], 'remodeled': [1565], 'revealed': [1567, 1682], 'quantitative': [1570], 'diffusion': [1571, 1685], 'tractography': [1573], 'framework': [1574], 'histological': [1576], 'validation.J': [1577], 'Cardiovasc': [1578, 1743], 'Magn': [1579], 'Reson.': [1580], '2012;': [1581], '14:70.': [1582], 'doi:': [1583, 1609, 1656, 1692, 1747], '10.1186/1532-429X-14-70CrossrefMedlineGoogle': [1584], 'Scholar2.': [1585], 'LeGrice': [1586], 'IJ,': [1587], 'Takayama': [1588], 'Y,': [1589, 1623], 'Covell': [1590], 'JW.': [1591], 'Transverse': [1592], 'provides': [1598], 'wall': [1604], 'thickening.Circ': [1605], 'Res.': [1606], '1995;': [1607], '77:182–193.': 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