{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T18:00:29Z","timestamp":1781373629688,"version":"3.54.1"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Sick sinus syndrome (SSS) is associated with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF). However, diagnosing HFpEF in patients with SSS and determining its prognosis are challenging. The European Society of Cardiology has recommended the HFA\u2010PEFF score for HFpEF diagnosis. In this study, we utilized the HFA\u2010PEFF score to diagnose HFpEF in patients with SSS and preserved ejection fraction, comparing the prognosis and AF burden between those diagnosed with HFpEF and those without.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified 131 patients with symptomatic SSS and preserved ejection fraction who underwent pacemaker implantation between January 2019 and December 2021. Of these, 52 (39.7%) had an HFA\u2010PEFF score\u2009\u22655 and met the diagnostic criteria for HFpEF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with HFpEF experienced more cardiovascular events (28.8% vs. 11.4%; <jats:italic>p<\/jats:italic>\u2009=\u2009.009) within 3\u2009years than those without HFpEF. The median duration of AF per day during the first year was significantly longer in the HFpEF group (10 vs. 30\u2009min\/day, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Additionally, these patients had a higher incidence of AF lasting for \u22657\u2009days (32.9% vs. 16.9%; <jats:italic>p<\/jats:italic>\u2009=\u2009.038) within 3\u2009years. A simplified HFA\u2010PEFF score incorporating E\/e\u2032, tricuspid regurgitation peak gradient, left atrial volume index, and brain natriuretic peptide predicted cardiovascular events and AF burden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients diagnosed with HFpEF using the HFA\u2010PEFF score have a higher incidence of cardiovascular events and a greater AF burden within 3\u2009years after pacemaker implantation for SSS. The HFA\u2010PEFF score may be useful for risk stratification in these patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.70088","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T09:40:11Z","timestamp":1747042811000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The <scp>HFA<\/scp>\u2010<scp>PEFF<\/scp> score and outcomes in patients with sick sinus syndrome and preserved ejection fraction after pacemaker implantation"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2918-606X","authenticated-orcid":false,"given":"Hironobu","family":"Sumiyoshi","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine  Tokyo Japan"},{"name":"Department of Cardiovascular Medicine Kurashiki Central Hospital  Kurashiki 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.15202"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euae204"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2024.05.007"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.08.048"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.054976"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2025.133022"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz641"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13302"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.09.027"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14876"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2016.10.005"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.119.006331"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2022.5320"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.0675"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00681.2004"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2009.08.008"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-19-0342"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2021.04.023"}],"container-title":["Journal 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