{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:08:11Z","timestamp":1784956091206,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) is the most common arrhythmia and a major cause of ischemic stroke recurrence. Cryptogenic stroke (CS) survivors face a higher risk for newly diagnosed AF (NDAF), with subtle ECG markers\u2014prolonged P\u2010wave duration (PWDur) and increased P\u2010wave dispersion (PWDis)\u2014potentially serving as early indicators. We aimed to quantify baseline PWDur and PWDis differences between CS survivors with NDAF and those in sinus rhythm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Following PRISMA guidelines, we systematically searched nine databases through January 2025 for observational studies assessing baseline P\u2010wave indices in adult CS patients in sinus rhythm. Data extraction and risk of bias assessment using the ROBINS\u2010E tool were performed independently. Pooled mean differences (MD) with 95% confidence intervals (CI) were calculated using a random\u2010effects inverse\u2010variance model. Subgroup\/sensitivity analyses were conducted by age groups, male proportion, region, follow\u2010up duration, percentage of comorbidities, AF definition and detection methods, and ECG parameter. Heterogeneity was assessed using Cochran's\n                      <jats:italic>Q<\/jats:italic>\n                      ,\n                      <jats:italic>\u03c4<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      , and\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      and interpreted using Cochrane thresholds; certainty was appraised with GRADE.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten studies, encompassing 1508 patients (mean age 66.72\u2009\u00b1\u200913.74\u2009years; 55.7% male), met the inclusion criteria. Baseline PWDur was longer in the NDAF (MD 6.36\u2009ms, 95% CI: 0.69\u201312.03,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200973%, GRADE: moderate). Sensitivity analysis confirmed the robustness. PWDis remained non\u2010significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prolonged baseline PWDur may serve as a non\u2010invasive marker of atrial conduction abnormalities and a predictor of AF in CS survivors. Larger prospective studies are needed to validate its role in risk stratification and secondary stroke prevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO: CRD42025646135<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.70209","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T07:21:21Z","timestamp":1761117681000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Newly Diagnosed Atrial Fibrillation Indicators in Cryptogenic Stroke Survivors' P\u2010Wave Indices: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3699-3763","authenticated-orcid":false,"given":"Haikal","family":"Balweel","sequence":"first","affiliation":[{"name":"Department of Cardiology Gatot Soebroto Army Central Hospital  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3244-2350","authenticated-orcid":false,"given":"Surya Sinaga","family":"Immanuel","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences Atma Jaya Catholic University of Indonesia  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8042-5807","authenticated-orcid":false,"given":"Jordan","family":"Budiono","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences Atma Jaya Catholic University of Indonesia  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6390-1450","authenticated-orcid":false,"given":"Fransiskus Xaverius","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences Atma Jaya Catholic University of Indonesia  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3537-4312","authenticated-orcid":false,"given":"Yeziel","family":"Sayogo","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences Atma Jaya Catholic University of Indonesia  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6083-8989","authenticated-orcid":false,"given":"Novaro Adeneur","family":"Tafriend","sequence":"additional","affiliation":[{"name":"Department of Cardiology Gatot Soebroto Army Central Hospital  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3123-5078","authenticated-orcid":false,"given":"Agus","family":"Harsoyo","sequence":"additional","affiliation":[{"name":"Department of Cardiology Gatot Soebroto Army Central Hospital  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.019893"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1747493019897870"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100041\u20101726332"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0002\u20109343(02)01479\u20101"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.031508"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ane.13093"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.25122\/jml\u20102021\u20100361"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rec.2017.02.019"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2023.12.003"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00031.2009"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ipej.2016.10.002"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euaa132"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14070"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2019.01.089"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hjc.2023.03.007"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.12016"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2024.108602"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39057.406644.68"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.5867\/medwave.2021.02.8109"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1187"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2018.04.294"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392\u2010019\u201001501\u20102"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2018.10.020"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9041134"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2020.11.019"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1159\/000512179"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.14418"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euac092"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S406546"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12206566"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072\u2010024\u201007548\u2010y"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2014.10.009"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840\u2010013\u20109851\u20101"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1161\/str.46.suppl_1.22"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.2174\/1871529X19666190410145501"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.903778"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.04.026"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ipej.2025.06.006"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.839398"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840\u2010022\u201001147\u20107"}],"container-title":["Journal of Arrhythmia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/joa3.70209","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T14:47:25Z","timestamp":1761662845000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/joa3.70209"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":42,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/joa3.70209"],"URL":"https:\/\/doi.org\/10.1002\/joa3.70209","archive":["Portico"],"relation":{},"ISSN":["1880-4276","1883-2148"],"issn-type":[{"value":"1880-4276","type":"print"},{"value":"1883-2148","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-06-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70209"}}