{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:03:16Z","timestamp":1791295396777,"version":"4.1.0"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"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":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardioneuroablation (CNA) targets atrial ganglionated plexuses (GP) to treat vagally mediated bradyarrhythmias. Automated electrogram fractionation mapping has been proposed as a surrogate tool for GP localization, but optimal parameter settings remain undefined. We aimed to systematically evaluate automated fractionation mapping parameters and their association with autonomic responses during ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from 26 patients were analyzed, including 12 patients undergoing atrial fibrillation (AF) ablation in sinus rhythm and 14 patients undergoing CNA. Using high\u2010density electroanatomical mapping, three predefined values were tested for each fractionation parameter\u2014signal width, refractoriness, and amplitude threshold\u2014yielding 27 automated configurations. A purely anatomical localization strategy was also evaluated. In the AF cohort, all configurations were systematically assessed, generating 336 fractionation maps and 870 ablation sites. Autonomic response during radiofrequency delivery was defined as an absolute RR interval change &gt;\u200910%. Selected high\u2010performing configurations were subsequently evaluated in the CNA cohort (614 ablation sites).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the AF cohort, 25 of 27 configurations showed a significant association with autonomic response. After Bonferroni correction, 15 configurations remained significant. The configuration with signal width 15\u2009ms, refractoriness 25\u2009ms, and amplitude threshold 0.05\u2009mV demonstrated the highest sensitivity, although several configurations showed comparable performance. When evaluated in the CNA cohort, this configuration yielded a sensitivity of 74.1% and specificity of 73.9%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This pilot study provides a reproducible framework for evaluating automated fractionation mapping parameters associated with autonomic responses during CNA. The findings support biologically plausible parameter\u2013performance relationships and identify parameter ranges potentially suitable for procedural use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.70423","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:26:01Z","timestamp":1784179561000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fractionated Atrial Electrograms Identify Sites of Autonomic Responses During Pulmonary Vein Isolation: Insights for Cardioneuroablation"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2736-2496","authenticated-orcid":false,"given":"Juan F.","family":"Agudelo\u2010Uribe","sequence":"first","affiliation":[{"name":"Hemodynamics and Interventional Cardiology Department CardioVID Clinic  Medell\u00edn Antioquia Colombia"},{"name":"International Doctoral School CEINDO Universidad CEU San Pablo  Boadilla del Monte Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Correa\u2010Vel\u00e1squez","sequence":"additional","affiliation":[{"name":"Hemodynamics and Interventional Cardiology Department CardioVID Clinic  Medell\u00edn Antioquia Colombia"},{"name":"International Doctoral School CEINDO Universidad CEU San Pablo  Boadilla del Monte Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan D.","family":"Ram\u00edrez\u2010Barrera","sequence":"additional","affiliation":[{"name":"Hemodynamics and Interventional Cardiology Department CardioVID Clinic  Medell\u00edn Antioquia Colombia"},{"name":"International Doctoral School CEINDO Universidad CEU San Pablo  Boadilla del Monte Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"Londo\u00f1o\u2010Arango","sequence":"additional","affiliation":[{"name":"Electrophysiology Field Clinical Specialist II Abbott Colombia  Medellin Antioquia Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8001-9398","authenticated-orcid":false,"given":"Teresa","family":"Barrio\u2010L\u00f3pez","sequence":"additional","affiliation":[{"name":"Electrophysiology Laboratory and Arrhythmia Unit HM CIEC Madrid (Centro Integral de Enfermedades Cardiovasculares), Hospital Universitario HM Montepr\u00edncipe, HM Hospitales  Boadilla del Monte Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria HM Hospitales  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Almendral","sequence":"additional","affiliation":[{"name":"Electrophysiology Laboratory and Arrhythmia Unit HM CIEC Madrid (Centro Integral de Enfermedades Cardiovasculares), Hospital Universitario HM Montepr\u00edncipe, HM Hospitales  Boadilla del Monte Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria HM Hospitales  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097\u20100185(199702)247:2<289::AID\u2010AR15>3.0.CO;2\u2010L"},{"key":"e_1_2_13_3_1","first-page":"198","article-title":"Selective Vagal Innervation of the Heart","volume":"16","author":"Randall W. 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