{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:54:34Z","timestamp":1781589274906,"version":"3.54.5"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:00:00Z","timestamp":1775865600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:00:00Z","timestamp":1775865600000},"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":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) after pacemaker (PM) implantation is associated with adverse outcomes; however, the relationship between left atrial remodeling, device type, and ventricular pacing burden remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to investigate (1) whether post\u2010implantation changes in left atrial diameter (\u0394LAD) are associated with incident AF; (2) differences in AF and \u0394LAD between TVP and LP; and (3) whether mean ventricular pacing percentage (Vp%) modifies device\u2010related effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included patients without a prior history of AF who underwent PM implantation. The primary outcome was defined as incident clinical AF, which was analyzed using Cox hazard models. Mechanistic models incorporating Vp% and paced QRS duration were also evaluated. Interaction analyses were performed using mean\u2010centered Vp % (device \u00d7 Vp) and Vp%\u2010stratified analyses. To mitigate reverse causality, a landmark analysis excluding AF events within 1 year after implantation was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the pooled Cox analyses, \u0394LAD was independently associated with incident AF (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). No significant difference in \u0394LAD was observed between the TVP and LP groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.417). In models adjusted for \u0394LAD, LP was associated with a significantly lower risk of AF (device,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049; \u0394LAD,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Vp% and paced QRS duration were not significant main effects. However, a significant device\u2009\u00d7\u2009Vp interaction was observed in the mean\u2010centered interaction models (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022). In landmark analyses, \u0394LAD remained associated with AF beyond 1 year (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0013).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Left atrial remodeling independently predicted incident AF after pacemaker implantation. LP was associated with a lower AF risk, with effects modified by the pacing burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70341","type":"journal-article","created":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T12:05:26Z","timestamp":1775909126000},"page":"1230-1240","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Left Atrial Remodeling After Pacemaker Implantation Predicts Incident Atrial Fibrillation: Comparison of Leadless and Transvenous Devices"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1521-8833","authenticated-orcid":false,"given":"Naoya","family":"Inoue","sequence":"first","affiliation":[{"name":"Department of Cardiology Chutoen General Medical Center Kakegawa Japan"},{"name":"Department of Cardiology Nagoya University Graduate School of Medicine Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Iwata","sequence":"additional","affiliation":[{"name":"Department of Cardiology Nagoya University Graduate School of Medicine Nagoya Japan"},{"name":"Department of Cardiology Toyota Kosei Hospital Toyota Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuji","family":"Morikawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology Chutoen General Medical Center Kakegawa Japan"},{"name":"Department of Cardiology Nagoya University Graduate School of Medicine Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyoaki","family":"Murohara","sequence":"additional","affiliation":[{"name":"Department of Cardiology Nagoya University Graduate School of Medicine Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,11]]},"reference":[{"key":"e_1_2_14_2_1","article-title":"Benefits of Upgrading Right Ventricular to Biventricular Pacing in Heart Failure Patients With Atrial Fibrillation","volume":"26","author":"Merkely B.","year":"2024","journal-title":"Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology: Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.15121"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-023-01650-5"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000072769.17295.B1"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.89.2.724"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.107.754564"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.4065\/76.5.467"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.15363"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13851"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.07.024"},{"key":"e_1_2_14_12_1","first-page":"1435","article-title":"Comparison of the Influence of Right Atrial Septal Pacing and Appendage Pacing on an Atrial Function and Atrial Fibrillation in the Clinical Situation","volume":"9","author":"Tanaka M.","year":"2016","journal-title":"Journal of Atrial Fibrillation"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00059-017-4589-7"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euu344"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2025.12.003"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/suaa094"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.15759"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.7.1954"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1098\/rsfs.2023.0041"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eut436"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.03.079"}],"container-title":["Journal of Cardiovascular 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