{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T06:48:13Z","timestamp":1782715693213,"version":"3.54.5"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) and sick sinus syndrome (SSS) frequently coexist and may share common atrial structural and electrophysiological remodeling substrates. Left ventricular (LV) diastolic dysfunction frequently coexists with AF; however, its association with subsequent detection of SSS and AF remains incompletely understood. This study investigated whether LV diastolic dysfunction is associated with the detection of SSS and AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included patients who underwent insertable cardiac monitor implantation for recurrent unexplained syncope. Patients with prior AF, LV ejection fraction &lt;\u200950%, or without remote monitoring were excluded. LV diastolic dysfunction was assessed using the HFA\u2010PEFF score. The primary endpoints were SSS requiring pacemaker implantation and AF during follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 164 patients (median age 71\u2009years; 34.1% women; median follow\u2010up 35\u2009months), SSS was detected in 31 patients (18.9%), and AF episodes lasting \u2265\u20096\u2009min were detected in 48 patients (29.3%). Patients with high HFA\u2010PEFF scores (5, 6) had a significantly higher risk of detection of SSS and AF. The HFA\u2010PEFF score remained independently associated with SSS (hazard ratio [HR], 1.51; 95% confidence interval [CI], 1.07\u20132.13;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021) and AF lasting \u2265\u20096\u2009min (HR, 1.94; 95% CI, 1.40\u20132.67;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) after multivariable adjustment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LV diastolic dysfunction, as quantified by the HFA\u2010PEFF score, is independently associated with the detection of SSS and AF, suggesting a potential association between LV diastolic dysfunction and arrhythmogenic atrial remodeling substrates.<\/jats:p>\n                  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