{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T17:41:41Z","timestamp":1773423701466,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":0,"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":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary vein isolation (PVI) is central to controlling paroxysmal atrial fibrillation (AF). Pulsed\u2010field ablation (PFA) offers a non\u2010thermal alternative to conventional thermal techniques. The study compares changes in P\u2010wave parameters following PFA, radiofrequency ablation (RF), and cryoballoon ablation (Cryo).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analysed 283 patients undergoing first\u2010time PVI (RF 101, Cryo 125, PFA 57). Digital electrocardiograms (ECGs) were evaluated for P\u2010wave duration (PWD), voltage (PWV), dispersion (PWDisp), and terminal force in lead V1 (PTFV1) before and immediately after ablation. AF recurrence was assessed at 12\u2009months. Analyses were adjusted for left atrial volume index (LAVI) and post\u2010procedural anti\u2010arrhythmic drug (AAD) use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 12\u2009months, 215 patients (76%) remained free of AF (RF 76%, Cryo 74%, PFA 79%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.78). Baseline PWD was 128.5\u2009\u00b1\u200914\u2009ms (RF), 123.7\u2009\u00b1\u200915\u2009ms (Cryo), and 124.2\u2009\u00b1\u200916\u2009ms (PFA). Post\u2010ablation, mean \u0394PWD was +12.2\u2009ms (RF), +8.5\u2009ms (Cryo), and\u2009+\u20094.7\u2009ms (PFA). PTFV1 decreased after all modalities: RF \u22123.3 to \u22124.6\u2009mm\u00b7ms (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), Cryo \u22123.4 to \u22125.3\u2009mm\u00b7ms (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), PFA \u22123.6 to \u22125.2\u2009mm\u00b7ms (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). No significant intergroup differences were observed (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.39). Patients with AF recurrence (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200968) had longer baseline PWD (128\u2009\u00b1\u200916 vs. 125\u2009\u00b1\u200914\u2009ms,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.12), longer post\u2010procedural PWD (138\u2009\u00b1\u200917 vs. 129\u2009\u00b1\u200915\u2009ms,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), and larger LAVI (29.1\u2009\u00b1\u20097.9 vs. 25.3\u2009\u00b1\u20098.5\u2009mL\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). In multivariable Cox models, increased post\u2010procedural PWD independently predicted recurrence (HR: RF 1.17, Cryo 1.14, PFA 1.13; all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PFA, RF, and Cryo produce similar acute ECG changes. Post\u2010procedural PWD was the strongest predictor of AF recurrence, independent of atrial size and AAD use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.70224","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T08:18:12Z","timestamp":1763367492000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["P\u2010Wave Parameter Changes After Pulsed\u2010Field Ablation, Cryoballoon Ablation and Radiofrequency Ablation for Paroxysmal Atrial Fibrillation: An Observational Cohort Study"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4374-7476","authenticated-orcid":false,"given":"Ibrahim","family":"Antoun","sequence":"first","affiliation":[{"name":"Department of Cardiology University Hospitals of Leicester NHS Trust, Glenfield Hospital  Leicester UK"},{"name":"Department of Cardiovascular Sciences, Clinical Science Wing University of Leicester, Glenfield Hospital  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Abdelrazik","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospitals of Leicester NHS Trust, Glenfield Hospital  Leicester UK"},{"name":"Department of Cardiovascular Sciences, Clinical Science Wing University of Leicester, Glenfield Hospital  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Engineering, University of Leicester  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Eldesouky","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospitals of Leicester NHS Trust, Glenfield Hospital  Leicester UK"},{"name":"Department of Cardiovascular Sciences, Clinical Science Wing University of Leicester, Glenfield Hospital  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaung Myat","family":"Thu","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospitals of Leicester NHS Trust, Glenfield Hospital  Leicester UK"},{"name":"Department of Cardiovascular Sciences, Clinical Science Wing University of Leicester, Glenfield Hospital  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riyaz","family":"Somani","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospitals of Leicester NHS Trust, Glenfield Hospital  Leicester UK"},{"name":"Department of Cardiovascular Sciences, Clinical Science Wing University of Leicester, Glenfield Hospital  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. Andr\u00e9","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, Clinical Science Wing University of Leicester, Glenfield Hospital  Leicester UK"},{"name":"National Institute for Health Research Leicester Research Biomedical Centre  Leicester UK"},{"name":"Leicester British Heart Foundation Centre of Research Excellence, Glenfield Hospital  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"e_1_2_11_2_1","article-title":"Atrial Fibrillation Inpatient Management Patterns and Clinical Outcomes During the Conflict in Syria: An Observational Cohort Study","author":"Antoun I.","year":"2024","journal-title":"Perfusion"},{"key":"e_1_2_11_3_1","article-title":"Incidence, Outcomes, and Predictors of New Heart Failure in Syrian Conflict\u2010Affected Population Following Hospitalization for Atrial Fibrillation: A Retrospective Cohort Study","volume":"40","author":"Antoun I.","year":"2024","journal-title":"Perfusion"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hroo.2024.05.010"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/03000605251314807"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.16579"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hroo.2024.12.010"},{"key":"e_1_2_11_8_1","article-title":"Global Epidemiology of Atrial Fibrillation: An Increasing Epidemic and Public Health Challenge","volume":"16","author":"Lippi G.","year":"2020","journal-title":"International Journal of Stroke"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw285"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.063988"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.05.032"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2024.1417029"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2019.10.002"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd11090277"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040297"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/circ.150.suppl_1.4145890"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.120.008580"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccep.2025.02.002"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.124.012814"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.120.009229"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-022-01359-x"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.122.011598"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2013.07.373"},{"issue":"6","key":"e_1_2_11_24_1","first-page":"519","article-title":"P Wave Indices to Predict Atrial Fibrillation Recurrences Post Pulmonary Vein Isolation","volume":"101","author":"Salah A.","year":"2013","journal-title":"Arquivos Brasileiros de Cardiologia"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euac210"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2024.1467585"}],"container-title":["Journal of Arrhythmia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/joa3.70224","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T06:03:35Z","timestamp":1767074615000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/joa3.70224"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,17]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/joa3.70224"],"URL":"https:\/\/doi.org\/10.1002\/joa3.70224","archive":["Portico"],"relation":{},"ISSN":["1880-4276","1883-2148"],"issn-type":[{"value":"1880-4276","type":"print"},{"value":"1883-2148","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,17]]},"assertion":[{"value":"2025-09-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70224"}}