{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:04:57Z","timestamp":1788998697519,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Traditional classifications of atrioventricular nodal reentrant tachycardia (AVNRT) based on cardiac symptomatology, electrocardiographic findings, and reentrant circuits do not capture the full heterogeneity of AVNRT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study sought to identify distinct phenotypes among patients with AVNRT by using two\u2010step cluster analysis and to determine differential effects of phenotypes on clinical and procedural outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      All patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009305) underwent catheter ablation and ajmaline challenge testing. A two\u2010step cluster analysis was conducted using 17 demographic\/clinical, anthropometric, electrocardiographic, echocardiographic, and anatomic variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three distinct clinically and mechanistically relevant clusters were identified. Cluster 1 (Metabolic\/Structural Phenotype,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200944) patients were characterized by older age of onset of AVNRT (53.5\u2009\u00b1\u20098.5, 43.5\u2009\u00b1\u200915, and 24.7\u2009\u00b1\u200910.5 years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20094.9\u2009\u00d7\u200910\n                      <jats:sup>\u221231<\/jats:sup>\n                      ), shorter distance between coronary sinus floor and His bundle potential (22.7\u2009\u00b1\u20096.1, 24.7\u2009\u00b1\u20096.8, and 29\u2009\u00b1\u20097.5\u2009mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.3\u2009\u00d7\u200910\n                      <jats:sup>\u22127<\/jats:sup>\n                      ), higher prevalence of \u201ccorrelated\u201d (diagnosed \u2265\u20094 years before AVNRT onset) type 2 diabetes (100%, 0%, and 0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20095.9\u2009\u00d7\u200910\n                      <jats:sup>\u221267<\/jats:sup>\n                      ) and \u201ccorrelated\u201d (diagnosed \u2265\u20096 years before AVNRT onset) structural heart disease (86.4%, 100%, 0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20093.5\u2009\u00d7\u200910\n                      <jats:sup>\u221262<\/jats:sup>\n                      ) compared to Cluster 2 (Structural Phenotype,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200978) and Cluster 3 (Anatomic\/Genetic Phenotype,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009183) patients, respectively. Cluster 1 patients had higher prevalence of \u201cpro\u2010arrhythmia\u201d (new\u2010onset and\/or symptom worsening\/intolerance) with anti\u2010arrhythmic therapy and\/or non\u2010cardiac drugs (74.2%, 46.5%, and 31.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.5\u2009\u00d7\u200910\n                      <jats:sup>\u22124<\/jats:sup>\n                      ), AH prolongation\/AV\u2010VA block (20.5%, 7.7%, and 2.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20098.9\u2009\u00d7\u200910\n                      <jats:sup>\u22125<\/jats:sup>\n                      ) and aborted ablation (11.4%, 1.3%, and 0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20098.6\u2009\u00d7\u200910\n                      <jats:sup>\u22125<\/jats:sup>\n                      ) during EP study compared to Clusters 2 and 3 patients, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Phenomapping identified three clinically and mechanistically relevant phenotypes of AVNRT associated with clinical and procedural outcomes, underscoring the considerable heterogeneity of AVNRT and the importance of comorbidities and substrates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70439","type":"journal-article","created":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T13:26:54Z","timestamp":1785072414000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Phenomapping in Atrioventricular Nodal Reentrant Tachycardia: Mechanistic Insights and Therapeutic Implications"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4755-9165","authenticated-orcid":false,"given":"Can","family":"Hasdemir","sequence":"first","affiliation":[{"name":"Department of Cardiology Ege University School of Medicine  \u0130zmir T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umut","family":"Kocaba\u015f","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ba\u015fkent University \u0130zmir Hospital  \u0130zmir T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7120-4698","authenticated-orcid":false,"given":"Burcu","family":"Ya\u011fmur","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Kyrenia  Kyrenia Turkish Republic of Northern Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faruk","family":"Bulut","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ege University School of Medicine  \u0130zmir T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fclden","family":"Hakverdi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Faculty of Medicine Sivas Cumhuriyet University  Sivas T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet N.","family":"Orman","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics Ege University School of Medicine  \u0130zmir T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7349-1582","authenticated-orcid":false,"given":"Charles","family":"Antzelevitch","sequence":"additional","affiliation":[{"name":"Lankenau Institute for Medical Research  Wynnewood Pennsylvania USA"},{"name":"Lankenau Heart Institute  Wynnewood Pennsylvania USA"},{"name":"Kimmel Medical College Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.010637"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014106"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12265-017-9756-y"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2017.4665"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2021-319685"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90720-l"},{"key":"e_1_2_11_8_1","first-page":"829","volume-title":"Zipes and Jalife's Cardiac Electrophysiology: From Cell to Bedside","author":"Lockwood D. 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