{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T04:26:07Z","timestamp":1781929567913,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"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":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Atrial fibrosis is an important substrate for atrial fibrillation (AF), especially in structural heart disease. A previous study reported that pirfenidone, an antifibrotic agent, reduced atrial and left ventricular fibrosis in an animal model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The present research aims to evaluate the effects of pirfenidone on arrhythmic and clinical outcomes in patients with idiopathic pulmonary fibrosis (IPF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Our database of patients diagnosed with IPF between 2008 and 2023 was used to obtain echocardiography, electrocardiography (ECG), and 24\u2010h Holter monitoring data. The study included all patients with IPF treated with or without pirfenidone. We compared arrhythmic events, including AF, atrial premature complexes, atrial tachycardia, and ventricular arrhythmias, as well as clinical outcomes based on pirfenidone use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 248 patients with IPF (74.0\u2009\u00b1\u20098.9 years), 106 (41.2%) received pirfenidone. No differences in the baseline characteristics were observed. During a median 36\u2010month follow\u2010up period, a lower incidence of arrhythmic events (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and diastolic dysfunction (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025) were observed in the pirfenidone group. Univariate analysis showed associations between arrhythmic events and hypertension, coronary artery disease, higher body weight, longer PR interval, QRS duration, and absence of pirfenidone use. In a multivariable analysis, higher body weight and absence of pirfenidone use were independent risk factors for arrhythmic events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pirfenidone use to treat IPF was associated with fewer arrhythmic events and less diastolic dysfunction compared to patients who did not use pirfenidone during long\u2010term follow\u2010up. Additionally, obesity is associated with a higher incidence of arrhythmic events in patients with IPF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70269","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T04:55:22Z","timestamp":1769489722000},"page":"614-621","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Pirfenidone on Arrhythmic and Clinical Outcomes in Patients With Idiopathic Pulmonary Fibrosis"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2544-2422","authenticated-orcid":false,"given":"Sung Il","family":"Im","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology Kosin University Gospel Hospital, Kosin University College of Medicine Busan Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su Hyun","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology Kosin University Gospel Hospital, Kosin University College of Medicine Busan Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology Kosin University Gospel Hospital, Kosin University College of Medicine Busan Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bong Joon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology Kosin University Gospel Hospital, Kosin University College of Medicine Busan Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Ho","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology Kosin University Gospel Hospital, Kosin University College of Medicine Busan Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Won","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Pulmonology Kosin University Gospel Hospital, Kosin University College of Medicine Busan Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward P.","family":"Gerstenfeld","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"issue":"3","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"S24","DOI":"10.1016\/j.hrthm.2006.12.040","article-title":"Atrial Fibrosis and the Mechanisms of Atrial Fibrillation","volume":"4","author":"THt E.","year":"2007","journal-title":"Heart Rhythm: The Official Journal of the Heart 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