{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T09:21:44Z","timestamp":1758273704365,"version":"3.41.2"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:00:00Z","timestamp":1689724800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pulmonary vein isolation (PVI) is a cornerstone therapy for paroxysmal atrial fibrillation (PAF). The variations in nonlinear heart rate variability (HRV) between patients with and without recurrences remain unclear. We aimed to characterize the nonlinear HRV before and after PVI in patients with and without recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010five drug\u2010refractory PAF patients (56.0\u2009\u00b1\u20099.1\u2009years old, 20 males) who received PVI were enrolled. Holter electrocardiography were performed before, 1\u20133, and 6\u201312\u2009months after PVI. After 8.2\u2009\u00b1\u20092.5\u2009months of follow\u2010ups after PVI, patients were divided into two groups: the recurrence (<jats:italic>n<\/jats:italic>\u2009=\u20098) and non\u2010recurrence (<jats:italic>n<\/jats:italic>\u2009=\u200917) groups. Linear and nonlinear HRV variables were analyzed, including the Poincar\u00e9 Plot analysis and the Detrended Fluctuation Analysis (DFA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The non\u2010recurrence group, but not the recurrence group, had decreased high\u2010frequency component (HF), the root mean square of successive RR interval differences (RMSSD), and the Poincar\u00e9 Plot index SD1 1\u20133\u2009months after PVI and increased DFA<jats:sub>slope2<\/jats:sub> 6\u201312\u2009months after PVI. The non\u2010recurrence group's LF\/HF ratio and DFA<jats:sub>slope1<\/jats:sub> decreased significantly 1\u20133 and 6\u201312\u2009months after PVI, respectively, whereas there was no significant change in the recurrence group after PVI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Significantly reduced vagal tone 1\u20133\u2009months after PVI, increased long\u2010term fractal complexity 6\u201312\u2009months after PVI, and decreased sympathetic tone as well as short\u2010term fractal complexity 1\u20133 and 6\u201312\u2009months after PVI led to a better AF\u2010free survival after PVI. These findings suggest that neuromodulation and heart rate dynamics play crucial roles in AF recurrence following PVI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.13074","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T05:36:30Z","timestamp":1689831390000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Fractal complexity alternations in paroxysmal atrial fibrillation patients with and without recurrence after pulmonary vein isolation"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2345-0154","authenticated-orcid":false,"given":"Ting\u2010Wei Ernie","family":"Liao","sequence":"first","affiliation":[{"name":"Faculty of Medicine, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Division of Cardiology Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Institute of Clinical 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Chiao Tung University  Taipei Taiwan"},{"name":"Division of Cardiology Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Institute of Clinical Medicine Cardiovascular Research Institute National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5715-2070","authenticated-orcid":false,"given":"Yu\u2010Feng","family":"Hu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Division of Cardiology Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Institute of Clinical Medicine Cardiovascular Research Institute National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fa\u2010Po","family":"Chung","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Division of Cardiology Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Institute of Clinical Medicine Cardiovascular Research Institute National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tze\u2010Fan","family":"Chao","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Division of Cardiology Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Institute of Clinical Medicine Cardiovascular Research Institute National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u2010Nan","family":"Liao","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Division of Cardiology Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Institute of Clinical Medicine Cardiovascular Research Institute National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui\u2010Wen","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Engineering, Institute of Translational and Interdisciplinary Medicine National Central University  Taoyuan Taiwan"},{"name":"Medical Biodynamics Program, Division of Sleep and Circadian Disorders Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Men\u2010Tzung","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Engineering, Institute of Translational and Interdisciplinary Medicine National Central University  Taoyuan 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