{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:21:44Z","timestamp":1792686104190,"version":"4.5.0"},"reference-count":40,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T00:00:00Z","timestamp":1623974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006691","name":"Harvard Medical School","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008460","name":"National Center for Complementary and Integrative Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008460","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["heartrhythmopen.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Heart Rhythm O2"],"published-print":{"date-parts":[[2021,8]]},"DOI":"10.1016\/j.hroo.2021.06.003","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T00:48:54Z","timestamp":1624322934000},"page":"326-332","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":18,"title":["A SMART approach to reducing paroxysmal atrial fibrillation symptoms: Results from a pilot randomized controlled trial"],"prefix":"10.1016","volume":"2","author":[{"given":"Michelle L.","family":"Dossett","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma W.","family":"Needles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Donahue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Gadenne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A.","family":"Macklin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy N.","family":"Ruskin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Denninger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.hroo.2021.06.003_bib1","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1161\/01.CIR.0000140263.20897.42","article-title":"Lifetime risk for development of atrial fibrillation: the Framingham Heart Study","volume":"110","author":"Lloyd-Jones","year":"2004","journal-title":"Circulation"},{"key":"10.1016\/j.hroo.2021.06.003_bib2","doi-asserted-by":"crossref","first-page":"e101","DOI":"10.1016\/j.jacc.2010.09.013","volume":"57","author":"Fuster","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.hroo.2021.06.003_bib3","doi-asserted-by":"crossref","first-page":"338","DOI":"10.7326\/0003-4819-158-5-201303050-00007","article-title":"Cognitive impairment associated with atrial fibrillation: a meta-analysis","volume":"158","author":"Kalantarian","year":"2013","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.hroo.2021.06.003_bib4","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1378\/chest.07-0036","article-title":"Depression, anxiety, and quality of life in patients with atrial fibrillation","volume":"132","author":"Thrall","year":"2007","journal-title":"Chest"},{"key":"10.1016\/j.hroo.2021.06.003_bib5","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1016\/S0735-1097(00)00886-X","article-title":"The impairment of health-related quality of life in patients with intermittent atrial fibrillation: implications for the assessment of investigational therapy","volume":"36","author":"Dorian","year":"2000","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.hroo.2021.06.003_bib6","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.tcm.2015.04.008","article-title":"Behavioral influences on cardiac arrhythmias","volume":"26","author":"Lampert","year":"2016","journal-title":"Trends Cardiovasc Med"},{"key":"10.1016\/j.hroo.2021.06.003_bib7","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1038\/nrcardio.2017.189","article-title":"Effects of stress on the development and progression of cardiovascular disease","volume":"15","author":"Kivim\u00e4ki","year":"2018","journal-title":"Nat Rev Cardiol"},{"key":"10.1016\/j.hroo.2021.06.003_bib8","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1016\/j.jacc.2014.07.959","article-title":"Triggering of symptomatic atrial fibrillation by negative emotion","volume":"64","author":"Lampert","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.hroo.2021.06.003_bib9","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1016\/j.hrthm.2019.03.004","article-title":"Effect of \u03b2-blockers on triggering of symptomatic atrial fibrillation by anger or stress","volume":"16","author":"Lampert","year":"2019","journal-title":"Heart Rhythm"},{"key":"10.1016\/j.hroo.2021.06.003_bib10","first-page":"47","article-title":"Mind-body medicine: a model of the comparative clinical impact of the acute stress and relaxation responses","volume":"92","author":"Dusek","year":"2009","journal-title":"Minn Med"},{"key":"10.1016\/j.hroo.2021.06.003_bib11","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1089\/acm.2005.11.465","article-title":"Meditation reduces sympathetic activation and improves the quality of life in elderly patients with optimally treated heart failure: a prospective randomized study","volume":"11","author":"Curiati","year":"2005","journal-title":"J Altern Complement Med N Y N"},{"key":"10.1016\/j.hroo.2021.06.003_bib12","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1001\/jamainternmed.2013.13018","article-title":"Meditation programs for psychological stress and well-being: a systematic review and meta-analysis","volume":"174","author":"Goyal","year":"2014","journal-title":"JAMA Intern Med"},{"key":"10.1016\/j.hroo.2021.06.003_bib13","unstructured":"Hempel S, Taylor SL, Marshall NJ, et al. Evidence Map of Mindfulness [Internet]. Washington (DC): Department of Veterans Affairs (US); 2014. [cited 2019 Mar 25], http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK268640\/."},{"key":"10.1016\/j.hroo.2021.06.003_bib14","first-page":"205","article-title":"Mindfulness meditation for workplace wellness: an evidence map","volume":"63","author":"Hilton","year":"2019","journal-title":"Work Read Mass"},{"key":"10.1016\/j.hroo.2021.06.003_bib15","doi-asserted-by":"crossref","first-page":"129","DOI":"10.31083\/j.rcm.2019.03.517","article-title":"Modulation of the autonomic nervous system through mind and body practices as a treatment for atrial fibrillation","volume":"20","author":"Bashir","year":"2019","journal-title":"Rev Cardiovasc Med"},{"key":"10.1016\/j.hroo.2021.06.003_bib16","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1016\/j.jacc.2012.11.060","article-title":"Effect of yoga on arrhythmia burden, anxiety, depression, and quality of life in paroxysmal atrial fibrillation: the YOGA My Heart Study","volume":"61","author":"Lakkireddy","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.hroo.2021.06.003_bib17","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1177\/1474515116637734","article-title":"Effects of yoga in patients with paroxysmal atrial fibrillation - a randomized controlled study","volume":"16","author":"Wahlstrom","year":"2017","journal-title":"Eur J Cardiovasc Nurs"},{"key":"10.1016\/j.hroo.2021.06.003_bib18","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1177\/1474515118762796","article-title":"Effects of brief mindfulness-based cognitive behavioural therapy on health-related quality of life and sense of coherence in atrial fibrillation patients","volume":"17","author":"Malm","year":"2018","journal-title":"Eur J Cardiovasc Nurs"},{"key":"10.1016\/j.hroo.2021.06.003_bib19","doi-asserted-by":"crossref","first-page":"2314","DOI":"10.4022\/jafib.2314","article-title":"Meditation for improved clinical outcomes in patients with implantable defibrillators for heart failure - pilot study","volume":"12","author":"Aditee","year":"2020","journal-title":"J Atr Fibrillation"},{"key":"10.1016\/j.hroo.2021.06.003_bib20","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.psym.2012.09.001","article-title":"The development of a patient-centered program based on the relaxation response: the Relaxation Response Resiliency Program (3RP)","volume":"54","author":"Park","year":"2013","journal-title":"Psychosomatics"},{"key":"10.1016\/j.hroo.2021.06.003_bib21","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0140212","article-title":"Relaxation response and resiliency training and its effect on healthcare resource utilization","volume":"10","author":"Stahl","year":"2015","journal-title":"PloS One"},{"key":"10.1016\/j.hroo.2021.06.003_bib22","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/j.psym.2014.01.005","article-title":"Exploring the effectiveness of a modified comprehensive mind-body intervention for medical and psychologic symptom relief","volume":"55","author":"Vranceanu","year":"2014","journal-title":"Psychosomatics"},{"key":"10.1016\/j.hroo.2021.06.003_bib23","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/j.ahj.2013.01.018","article-title":"Benefits and costs of intensive lifestyle modification programs for symptomatic coronary disease in Medicare beneficiaries","volume":"165","author":"Zeng","year":"2013","journal-title":"Am Heart J"},{"key":"10.1016\/j.hroo.2021.06.003_bib24","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0123861","article-title":"Genomic and clinical effects associated with a relaxation response mind-body intervention in patients with irritable bowel syndrome and inflammatory bowel disease","volume":"10","author":"Kuo","year":"2015","journal-title":"PloS One"},{"key":"10.1016\/j.hroo.2021.06.003_bib25","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s10995-019-02815-3","article-title":"A virtual resiliency intervention promoting resiliency for parents of children with learning and attentional disabilities: a randomized pilot trial","volume":"24","author":"Park","year":"2020","journal-title":"Matern Child Health J"},{"key":"10.1016\/j.hroo.2021.06.003_bib26","doi-asserted-by":"crossref","first-page":"2513","DOI":"10.1007\/s10803-019-03976-4","article-title":"A virtual resiliency intervention for parents of children with autism: a randomized pilot trial","volume":"50","author":"Kuhlthau","year":"2020","journal-title":"J Autism Dev Disord"},{"key":"10.1016\/j.hroo.2021.06.003_bib27","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1161\/CIRCEP.110.958033","article-title":"Development and validation of the Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) Questionnaire in patients with atrial fibrillation","volume":"4","author":"Spertus","year":"2011","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hroo.2021.06.003_bib28","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"key":"10.1016\/j.hroo.2021.06.003_bib29","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jad.2008.06.026","article-title":"The PHQ-8 as a measure of current depression in the general population","volume":"114","author":"Kroenke","year":"2009","journal-title":"J Affect Disord"},{"key":"10.1016\/j.hroo.2021.06.003_bib30","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.amjcard.2014.04.032","article-title":"New classification scheme for atrial fibrillation symptom severity and burden","volume":"114","author":"Koci","year":"2014","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.hroo.2021.06.003_bib31","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/0005-7967(90)90135-6","article-title":"Development and validation of the Penn State Worry Questionnaire","volume":"28","author":"Meyer","year":"1990","journal-title":"Behav Res Ther"},{"key":"10.1016\/j.hroo.2021.06.003_bib32","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1037\/0022-3514.54.6.1063","article-title":"Development and validation of brief measures of positive and negative affect: the PANAS scales","volume":"54","author":"Watson","year":"1988","journal-title":"J Pers Soc Psychol"},{"key":"10.1016\/j.hroo.2021.06.003_bib33","author":"Carver"},{"key":"10.1016\/j.hroo.2021.06.003_bib34","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2307\/2136404","article-title":"A global measure of perceived stress","volume":"24","author":"Cohen","year":"1983","journal-title":"J Health Soc Behav"},{"key":"10.1016\/j.hroo.2021.06.003_bib35","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1002\/jts.2490090305","article-title":"The Posttraumatic Growth Inventory: measuring the positive legacy of trauma","volume":"9","author":"Tedeschi","year":"1996","journal-title":"J Trauma Stress"},{"key":"10.1016\/j.hroo.2021.06.003_bib36","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s10862-006-9035-8","article-title":"Mindfulness and emotion regulation: the development and initial validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R)","volume":"29","author":"Feldman","year":"2007","journal-title":"J Psychopathol Behav Assess"},{"key":"10.1016\/j.hroo.2021.06.003_bib37","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"10.1016\/j.hroo.2021.06.003_bib38","doi-asserted-by":"crossref","DOI":"10.1001\/jama.2016.2323","article-title":"Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: a randomized clinical trial","volume":"315","author":"Cherkin","year":"2016","journal-title":"JAMA"},{"key":"10.1016\/j.hroo.2021.06.003_bib39","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1097\/BRS.0000000000002344","article-title":"Cost-effectiveness of mindfulness-based stress reduction versus cognitive behavioral therapy or usual care among adults with chronic low back pain","volume":"42","author":"Herman","year":"2017","journal-title":"Spine"},{"key":"10.1016\/j.hroo.2021.06.003_bib40","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1093\/europace\/eur194","article-title":"The cost of illness of atrial fibrillation: a systematic review of the recent literature","volume":"13","author":"Wolowacz","year":"2011","journal-title":"Europace"}],"container-title":["Heart Rhythm O2"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2666501821001124?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2666501821001124?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:25:17Z","timestamp":1762993517000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2666501821001124"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8]]},"references-count":40,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["S2666501821001124"],"URL":"https:\/\/doi.org\/10.1016\/j.hroo.2021.06.003","relation":{},"ISSN":["2666-5018"],"issn-type":[{"value":"2666-5018","type":"print"}],"subject":[],"published":{"date-parts":[[2021,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"A SMART approach to reducing paroxysmal atrial fibrillation symptoms: Results from a pilot randomized controlled trial","name":"articletitle","label":"Article Title"},{"value":"Heart Rhythm O2","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.hroo.2021.06.003","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 Heart Rhythm Society. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}