{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T21:36:03Z","timestamp":1775856963010,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"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":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Paroxysmal atrial fibrillation (PAF) patients do not invariably progress to persistent AF, with a consistent group of patients showing AF regression during follow\u2010up. The prognostic implications of spontaneous conversion (SCV) to sinus rhythm (SR) in those patients has never been evaluated yet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the long\u2010term prognostic impact of early SCV to SR in patients presenting with symptomatic, hemodynamically stable, PAF in the emergency department (ED).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive patients with symptomatic, hemodynamically stable PAF were included. Patients discharged in SR and followed\u2010up thereafter were stratified based on the occurrence of SCV within 6\u2009h from ED admission. Propensity score matching (PSM) was employed to adjust for relevant baseline differences. The primary outcome was a composite of progression to permanent AF, progression to persistent AF, initiation of antiarrhythmic drugs, AF ablation and need for pharmacologic or electrical cardioversion. Secondary outcomes included AF episodes frequency and individual components of the composite outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 158 patients, 52 experienced SCV while 106 required active cardioversion. After PSM, 52 matched pairs were analyzed. During a median follow\u2010up of 17.0 months (IQR: 12.8\u201321.3 months), the primary composite outcome occurred significantly less frequently in the SCV group compared to the non\u2010SCV group (21 vs. 41 events; log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). SCV was associated with a significant reduction of primary outcome occurrence (OR 0.361 [95% CI: 0.176; 0.739],\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value 0.005). The SCV group also exhibited a lower arrhythmic burden, with fewer AF episodes (median 1 [3] vs. 2 [4],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and reduced need for cardioversion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). The primary and secondary outcomes did not differ among SCV and non\u2010SCV groups in the unmatched population.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SCV in patients with PAF is associated with lower arrhythmic burden and reduced need for rhythm\u2010control strategies at follow\u2010up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70128","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T06:05:30Z","timestamp":1759471530000},"page":"3222-3230","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prognostic Impact of Spontaneous Conversion to Sinus Rhythm in Patients With Symptomatic Paroxysmal Atrial Fibrillation: A Propensity\u2010Matched Follow\u2010Up Study"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9480-1209","authenticated-orcid":false,"given":"Marco Valerio","family":"Mariani","sequence":"first","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological Aenesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tommaso","family":"Recchioni","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological Aenesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Pierucci","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological Aenesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Trivigno","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological Aenesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Cipollone","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological Aenesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele Maria","family":"Bruti","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological Aenesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7621-5776","authenticated-orcid":false,"given":"Domenico","family":"Laviola","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological Aenesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5092-3115","authenticated-orcid":false,"given":"Marta","family":"Palombi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological Aenesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8831-6178","authenticated-orcid":false,"given":"Andrea","family":"Matteucci","sequence":"additional","affiliation":[{"name":"Clinical and Rehabilitation Cardiology Division, San Filippo Neri Hospital Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5995-4963","authenticated-orcid":false,"given":"Agostino","family":"Piro","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological Aenesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Chimenti","sequence":"additional","affiliation":[{"name":"Department of Internal Clinical Aenesthesiological and Cardiovascular Sciences \u201cSapienza\u201d University of Rome Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gioacchino","family":"Galardo","sequence":"additional","affiliation":[{"name":"Department of Emergency Critical Care and Trauma Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Department of Emergency Critical Care and Trauma Rome Italy"},{"name":"Department of General and Specialistic Surgery \u201cSapienza\u201d University of Rome Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmine Dario","family":"Vizza","sequence":"additional","affiliation":[{"name":"Department of Internal Clinical Aenesthesiological and Cardiovascular Sciences \u201cSapienza\u201d University of Rome Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Lavalle","sequence":"additional","affiliation":[{"name":"Department of Internal Clinical Aenesthesiological and Cardiovascular Sciences \u201cSapienza\u201d University of Rome Rome 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