{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:17:22Z","timestamp":1788329842827,"version":"build-2803163510"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Periodic repolarization dynamics (PRD) is a novel ECG\u2010derived biomarker reflecting sympathetic activity\u2010associated oscillations in cardiac repolarization. We hypothesized that elevated PRD identifies patients after acute ischemic stroke who are at increased risk of developing atrial fibrillation detected after ischemic stroke or transient ischemic attack (AFDAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Between February 22, 2021 and May 5, 2023, 263 patients with acute ischemic stroke from the STROKE\u2010CARD cohort were prospectively enrolled. All patients were in sinus rhythm at baseline without prior or current atrial fibrillation. Within 5\u2009days after acute ischemic stroke, patients underwent a standardized 30\u2010minute high\u2010resolution ECG to assess PRD, heart rate variability, and supraventricular premature complexes per hour. AFDAS was identified through continuous in\u2010hospital monitoring, 6\u2010month follow\u2010ups, and electronic health record review. The CHASE\u2010LESS score, a clinical score comprising coronary heart disease, heart failure, age, stroke severity, hyperlipidemia, diabetes, and prior stroke\/transient ischemic attack, served as the clinical risk model for AFDAS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      During a median follow\u2010up of 17 (interquartile range, 12\u201326) months, AFDAS occurred in 25 of 263 patients (9.5%). Patients with AFDAS exhibited higher PRD values than those without (5.80 versus 2.93\u2009deg\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.005). In multivariable Cox regression, PRD independently predicted AFDAS (hazard ratio [HR], 1.27 [95% CI, 1.03\u20131.44];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.037), alongside supraventricular premature complexes frequency (HR, 1.02 [95% CI, 1.01\u20131.03];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). A model comprising PRD and supraventricular premature complexes per hour showed better discrimination than the CHASE\u2010LESS score alone, with an area under the curve of 0.82 versus 0.67, respectively (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Increased PRD and supraventricular premature complexes frequency independently predicted AFDAS and significantly improved risk prediction compared with the clinical CHASE\u2010LESS score.<\/jats:p>\n                  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Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1369-418X","authenticated-orcid":false,"given":"Christian","family":"Boehme","sequence":"additional","affiliation":[{"name":"Medical University of Innsbruck","place":["Innsbruck, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5576-6562","authenticated-orcid":false,"given":"Michael","family":"Knoflach","sequence":"additional","affiliation":[{"name":"Medical University of Innsbruck","place":["Innsbruck, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9836-2514","authenticated-orcid":false,"given":"Stefan","family":"Kiechl","sequence":"additional","affiliation":[{"name":"Medical University of Innsbruck","place":["Innsbruck, Austria"]},{"name":"VASCage\u2010Center for Clinical Stroke Research","place":["Innsbruck, 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