{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:53:24Z","timestamp":1791402804753,"version":"4.3.3"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,1,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Short ECG P\u2010wave duration has recently been demonstrated to be associated with higher risk of atrial fibrillation (AF). The aim of this study was to assess the rate of AF recurrence after pulmonary vein isolation in patients with a short P wave, and to mechanistically elucidate the observation by computer modeling.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 282 consecutive patients undergoing a first single\u2010pulmonary vein isolation procedure for paroxysmal or persistent AF were included. Computational models studied the effect of adenosine and sodium conductance on action potential duration and P\u2010wave duration (PWD). About 16% of the patients had a PWD of 110\u00a0ms or shorter (median PWD 126\u00a0ms, interquartile range, 115\u00a0ms\u2013138\u00a0ms; range, 71\u00a0ms\u2013180\u00a0ms). At Cox regression, PWD was significantly associated with AF recurrence (\n              <jats:italic>P<\/jats:italic>\n              =0.012). Patients with a PWD &lt;110\u00a0ms (hazard ratio [HR], 2.20; 95% CI, 1.24\u20133.88;\n              <jats:italic>P<\/jats:italic>\n              =0.007) and patients with a PWD \u2265140 (HR, 1.87, 95% CI, 1.06\u20133.30;\n              <jats:italic>P<\/jats:italic>\n              =0.031) had a nearly 2\u2010fold increase in risk with respect to the other group. In the computational model, adenosine yielded a significant reduction of action potential duration 90 (52%) and PWD (7%). An increased sodium conductance (up to 200%) was robustly accompanied by an increase in conduction velocity (26%), a reduction in action potential duration 90 (28%), and PWD (22%).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">One out of 5 patients referred for pulmonary vein isolation has a short PWD which was associated with a higher rate of AF after the index procedure. Computer simulations suggest that shortening of atrial action potential duration leading to a faster atrial conduction may be the cause of this clinical observation.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.018572","type":"journal-article","created":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T12:33:11Z","timestamp":1610022791000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Short P\u2010Wave Duration is a Marker of Higher Rate of Atrial Fibrillation Recurrences after Pulmonary Vein Isolation: New Insights into the Pathophysiological Mechanisms Through Computer Simulations"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2116-6993","authenticated-orcid":false,"given":"Angelo","family":"Auricchio","sequence":"first","affiliation":[{"name":"Division of Cardiology Cardiocentro Ticino Lugano Switzerland"},{"name":"Center for Computational Medicine in Cardiology Universit\u00e0 della Svizzera Italiana Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8391-8164","authenticated-orcid":false,"given":"Tardu","family":"\u00d6zkartal","sequence":"additional","affiliation":[{"name":"Division of Cardiology Cardiocentro Ticino Lugano Switzerland"},{"name":"Department of Cardiology Ospedale San Giovanni Bellinzona Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Salghetti","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre Postgraduate course in Cardiac Electrophysiology and PacingVrije Universiteit BrusselUniversitair Ziekenhuis Brussel Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3680-3123","authenticated-orcid":false,"given":"Laura","family":"Neumann","sequence":"additional","affiliation":[{"name":"Division of Cardiology Cardiocentro Ticino Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7432-0424","authenticated-orcid":false,"given":"Simone","family":"Pezzuto","sequence":"additional","affiliation":[{"name":"Center for Computational Medicine in Cardiology Universit\u00e0 della Svizzera Italiana Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Gharaviri","sequence":"additional","affiliation":[{"name":"Center for Computational Medicine in Cardiology Universit\u00e0 della Svizzera Italiana Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7748-1389","authenticated-orcid":false,"given":"Andrea","family":"Demarchi","sequence":"additional","affiliation":[{"name":"Division of Cardiology Cardiocentro Ticino Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1190-5967","authenticated-orcid":false,"given":"Maria Luce","family":"Caputo","sequence":"additional","affiliation":[{"name":"Division of Cardiology Cardiocentro Ticino Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Regoli","sequence":"additional","affiliation":[{"name":"Division of Cardiology Cardiocentro Ticino Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9351-0760","authenticated-orcid":false,"given":"Carlo","family":"De Asmundis","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre Postgraduate course in Cardiac Electrophysiology and PacingVrije Universiteit BrusselUniversitair Ziekenhuis Brussel Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian\u2010Battista","family":"Chierchia","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre Postgraduate course in Cardiac Electrophysiology and PacingVrije Universiteit BrusselUniversitair Ziekenhuis Brussel Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3172-6106","authenticated-orcid":false,"given":"Pedro","family":"Brugada","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre Postgraduate course in Cardiac Electrophysiology and PacingVrije Universiteit BrusselUniversitair Ziekenhuis Brussel Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Klersy","sequence":"additional","affiliation":[{"name":"Service of Clinical Epidemiology &amp; 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