{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T15:40:29Z","timestamp":1773416429669,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,1,7]],"date-time":"2019-01-07T00:00:00Z","timestamp":1546819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The\u00a0relationship between insulin resistance and atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Drug\u2010refractory 114 paroxysmal AF patients (89 males, 62\u2009\u00b1\u20098 years) who underwent successful PVI were enrolled. Homeostasis model assessment of insulin resistance (HOMA\u2010IR) was calculated\u00a0and a value of \u22652.5 was defined as insulin resistant. The left atrial volume index (LAVI) was measured using echocardiography before and 1 year after PVI. Tumor necrosis factor\u2010\u03b1 (TNF\u2010\u03b1) and TGF\u2010\u03b21 serum levels were measured before PVI, and the left atrium (LA) conduction velocity was calculated. The patients were divided into two groups (group 1: HOMA\u2010IR\u2009&lt;\u20092.5, n\u2009=\u200981; group 2: HOMA\u2010IR\u2009\u2265\u20092.5, n\u2009=\u200933).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The LAVI between the two groups before PVI did not significantly differ (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05), nor did TNF\u2010\u03b1 (7.7\u2009\u00b1\u20092.0 vs 7.5\u2009\u00b1\u20091.0\u2009pg\/mL; <jats:italic>P<\/jats:italic>\u2009=\u20090.149) or TGF\u2010\u03b21 (28.4\u2009\u00b1\u200912.0 vs 27.6\u2009\u00b1\u200910.3\u2009ng\/mL; <jats:italic>P<\/jats:italic>\u2009=\u20090.757). LAVI before and 1 year after PVI in each group did not change. The conduction velocity of group 2 was slower than that of group 1 (0.7\u2009\u00b1\u20090.1 vs 1.1\u2009\u00b1\u20090.3\u2009m\/s, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Kaplan\u2010Meier analysis showed significantly higher AF recurrence in group 2 than that in group 1 (\n<jats:italic>P<\/jats:italic>\u2009=\u20090.019). Cox multivariable analysis revealed that insulin resistance was an independent predictor of recurrence (hazard ratio 1.287, <jats:italic>P<\/jats:italic>\u2009=\u20090.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results suggest that insulin resistance promotes LA electrical remodeling and might be related to AF recurrence after PVI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.13827","type":"journal-article","created":{"date-parts":[[2018,12,21]],"date-time":"2018-12-21T14:18:14Z","timestamp":1545401894000},"page":"479-486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Clinical impact of insulin resistance on pulmonary vein isolation outcome in patients with paroxysmal atrial fibrillation"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6983-436X","authenticated-orcid":false,"given":"Naoko","family":"Hijioka","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6588-0764","authenticated-orcid":false,"given":"Masashi","family":"Kamioka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiyuki","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minoru","family":"Nodera","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinya","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5284-9538","authenticated-orcid":false,"given":"Takashi","family":"Kaneshiro","sequence":"additional","affiliation":[{"name":"Department of Arrhythmia and Cardiac Pacing Fukushima Medical University Fukushima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akiomi","family":"Yoshihisa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takafumi","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuchika","family":"Takeishi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Fukushima Medical University Fukushima 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