{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:50:17Z","timestamp":1791453017411,"version":"4.3.3"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Pulsed field ablation is now widely used for atrial fibrillation (AF) ablation, but atrial tachyarrhythmia recurrence remains common and postablation risk tools are limited. We assessed whether a validated sinus\u2011rhythm artificial intelligence\u2014 enabled ECG AF probability score, and its early postablation change, predicts recurrence after pulsed field ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We studied consecutive patients undergoing index pulsed field ablation across 3 Mayo Clinic sites (February 2024\u2013March 2025) with \u22651 sinus\u2011rhythm ECG within 180 days preprocedure. Baseline artificial intelligence\u2014enabled ECG AF score (range 0\u20131) was the mean across baseline ECGs. Recovery indices (RI30\/60\/90), defined as mean postprocedure artificial intelligence\u2014enabled ECG score within days 1\u201330\/60\/90 minus baseline, predicted post\u2011blanking recurrence using corresponding 30\u2011, 60\u2011, and 90\u2011day blanking windows. The primary outcome was time to first documented AF\/atrial flutter\/atrial tachycardia episode &gt;30 seconds, ascertained via clinic ECGs, ambulatory monitoring, and device interrogations. Cox regression adjusted for prespecified clinical and echocardiographic covariates assessed associations; Harrell C\u2011statistic quantified discrimination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Among 1052 patients (67\u00b110 years; 33% women), median baseline score was 0.35; 320 (30%) recurred over 188 days. Higher baseline score independently predicted recurrence (hazard ratio per 0.1 increase, 1.08 [95% CI, 1.03\u20131.14]). Scores rose on day 0 after ablation, then declined over subsequent weeks, with persistently higher, less\u2011improving trajectories among patients who recurred (time\u00d7recurrence interaction\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). Day 0 score was not independently associated with recurrence after adjustment. Attenuated early recovery (higher recovery index) was independently associated with recurrence, most robustly for RI-90 (hazard ratio per 0.1 increase, 1.15 [95% CI, 1.07\u20131.24]), and improved discrimination beyond baseline and covariates (C\u2011statistic, 0.63\u20130.67; \u0394C=0.04). Findings were consistent in a historical thermal ablation cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Baseline and early postablation dynamics of a sinus\u2011rhythm artificial intelligence\u2014enabled ECG AF probability score are associated with pulsed field ablation recurrence and may aid multivariable risk stratification; prospective validation is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.126.015183","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:00:54Z","timestamp":1791450054000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Serial Artificial Intelligence ECG-Derived Atrial Fibrillation Probability and Recurrence Risk After Pulsed Field Ablation"],"prefix":"10.1161","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9465-1047","authenticated-orcid":true,"given":"Mayank","family":"Sardana","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, AZ (M.S., J.F.R.-R., H.S.V., J.K., K.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8271-9128","authenticated-orcid":true,"given":"Juan F.","family":"Rodriguez-Riascos","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, AZ (M.S., J.F.R.-R., H.S.V., J.K., K.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2942-1031","authenticated-orcid":true,"given":"Hema S.","family":"Vemulapalli","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, AZ (M.S., J.F.R.-R., H.S.V., J.K., K.S.)."},{"name":"Department of Internal Medicine, Harlingen Medical Center, TX (H.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6073-2009","authenticated-orcid":true,"given":"James","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, AZ (M.S., J.F.R.-R., H.S.V., J.K., K.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9706-7900","authenticated-orcid":true,"given":"Zachi I.","family":"Attia","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, MN (Z.I.A., J.W., K.M., P.A.F., P.A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3370-4461","authenticated-orcid":true,"given":"Julia","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, MN (Z.I.A., J.W., K.M., P.A.F., P.A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7048-2699","authenticated-orcid":true,"given":"Kathryn","family":"Mangold","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, MN (Z.I.A., J.W., K.M., P.A.F., P.A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5052-2948","authenticated-orcid":true,"given":"Paul A.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, MN (Z.I.A., J.W., K.M., P.A.F., P.A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4308-0456","authenticated-orcid":true,"given":"Peter A.","family":"Noseworthy","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, MN (Z.I.A., J.W., K.M., P.A.F., 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Arrhythmia and Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCEP.126.015183","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:00:54Z","timestamp":1791450054000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCEP.126.015183"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":22,"alternative-id":["10.1161\/CIRCEP.126.015183"],"URL":"https:\/\/doi.org\/10.1161\/circep.126.015183","relation":{},"ISSN":["1941-3149","1941-3084"],"issn-type":[{"value":"1941-3149","type":"print"},{"value":"1941-3084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]},"assertion":[{"value":"2026-04-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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