{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T08:53:35Z","timestamp":1770281615215,"version":"3.49.0"},"reference-count":17,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Tech Launch Arizona Asset Development Grant","award":["UA17-095"],"award-info":[{"award-number":["UA17-095"]}]},{"name":"WARMER Research Foundation"},{"name":"Sarver Heart Center"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Persistent atrial fibrillation (AFib) is the most common chronic arrhythmia in adults in the United States and is associated with significant morbidity, including thromboembolic events, stroke, and heart failure. Despite available therapies such as catheter ablation and antiarrhythmic drugs, AFib remains incurable for many patients. Our study aims to develop a large-animal model of AFib in Yucatan miniswine to support investigation of new therapeutic approaches for this disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Yucatan miniswine were selected for their physiological similarity to humans and suitable size for long-term studies. Each animal was initially fitted with an external FitBark 2.0 collar to track activity as a surrogate for quality of life. Animals then underwent implantation of an atrial pacing lead in the right atrial appendage, a pacing generator, and an insertable cardiac monitor (ICM Reveal LINQ\u2122) implanted subcutaneously along the left scapula. One week after the pacemaker implantation, animals underwent rapid atrial pacing to induce persistent AFib. All procedures were performed in accordance with relevant institutional and regulatory guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Atrial fibrillation was successfully induced in 4 of 6 animals within 80.3\u2009\u00b1\u200922.3 days of initiating pacing with three animals going into persistent AFib and one animal going into paroxysmal AFib. The definition of persistent AFib was that animals remained in AFib for more than 14 days after pacing was discontinued. Paroxysmal AFib was defined as AFib lasting less than 14 days. Activity levels decreased following persistent AFib onset, indicating a decline in overall health and quality of life. Histopathological analyses showed significant increases in fibrosis and loss of atrial cardiomyocytes after persistent AFib was induced in swine. Several anatomical and technical challenges, particularly related to vascular access and cardiac dimensions, were overcome through customized surgical strategies, including jugular venous cut-downs, lateral cervical ICM implantation, long vascular sheaths, custom styluses, and perioperative antibiotic coverage. These innovations were critical to establishing a robust and reproducible persistent AFib model.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0340985","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T18:32:22Z","timestamp":1770229942000},"page":"e0340985","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Yucatan Miniswine Model of Atrial Fibrillation: Clinical Relevance"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2287-0424","authenticated-orcid":true,"given":"Pouria","family":"Mostafizi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5120-957X","authenticated-orcid":true,"given":"Eli","family":"Lefkowitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Ref","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9166-5401","authenticated-orcid":true,"given":"Fox","family":"Bravo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Benson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deirdre","family":"O\u2019Donnell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0065-7347","authenticated-orcid":true,"given":"Kenneth","family":"Fox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Grijalva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Kaye","family":"Pierce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Gorman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"McArthur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherry","family":"Daugherty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7034-5413","authenticated-orcid":true,"given":"Anil","family":"Shendge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1541-7023","authenticated-orcid":true,"given":"Amitabh C.","family":"Pandey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Lancaster","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jen Watson","family":"Koevary","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7943-1871","authenticated-orcid":true,"given":"Steven","family":"Goldman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Talal","family":"Moukabary","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"issue":"2","key":"pone.0340985.ref001","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1177\/1747493019897870","article-title":"Global epidemiology of atrial fibrillation: an increasing epidemic and public health challenge","volume":"16","author":"G Lippi","year":"2021","journal-title":"Int J Stroke"},{"issue":"5","key":"pone.0340985.ref002","doi-asserted-by":"crossref","DOI":"10.7326\/AITC201703070","article-title":"Atrial fibrillation","volume":"166","author":"P Zimetbaum","year":"2017","journal-title":"Ann Intern Med"},{"issue":"7","key":"pone.0340985.ref003","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1161\/01.CIR.92.7.1954","article-title":"Atrial fibrillation begets atrial fibrillation. a study in awake chronically instrumented goats","volume":"92","author":"MC Wijffels","year":"1995","journal-title":"Circulation"},{"issue":"4","key":"pone.0340985.ref004","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.cardiores.2003.12.013","article-title":"Pathophysiological findings in a model of persistent atrial fibrillation and severe congestive heart failure","volume":"61","author":"A Bauer","year":"2004","journal-title":"Cardiovasc Res"},{"key":"pone.0340985.ref005","doi-asserted-by":"crossref","first-page":"159","DOI":"10.3389\/fphar.2020.00159","article-title":"The KCa2 channel inhibitor AP30663 selectively increases atrial refractoriness, converts vernakalant-resistant atrial fibrillation and prevents its reinduction in conscious pigs","volume":"11","author":"JG Diness","year":"2020","journal-title":"Front Pharmacol"},{"issue":"7","key":"pone.0340985.ref006","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1016\/j.hlc.2020.11.007","article-title":"Factors contributing to exercise intolerance in patients with atrial fibrillation","volume":"30","author":"AD Elliott","year":"2021","journal-title":"Heart Lung Circ"},{"issue":"4","key":"pone.0340985.ref007","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1111\/j.1542-474X.2011.00463.x","article-title":"Exercise heart rate acceleration patterns during atrial fibrillation and sinus rhythm","volume":"16","author":"J Buber","year":"2011","journal-title":"Ann Noninvasive Electrocardiol"},{"issue":"1","key":"pone.0340985.ref008","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1161\/CIRCRESAHA.120.316366","article-title":"Animal models of atrial fibrillation","volume":"127","author":"D Sch\u00fcttler","year":"2020","journal-title":"Circ Res"},{"key":"pone.0340985.ref009","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.yjmcc.2023.03.006","article-title":"Optogenetic termination of atrial tachyarrhythmias by brief pulsed light stimulation","volume":"178","author":"M Nakao","year":"2023","journal-title":"J Mol Cell Cardiol"},{"issue":"3","key":"pone.0340985.ref010","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1111\/joim.13654","article-title":"Light transmittance in human atrial tissue and transthoracic illumination in rats support translatability of optogenetic cardioversion of atrial fibrillation","volume":"294","author":"ECA Nyns","year":"2023","journal-title":"J Intern Med"},{"issue":"5","key":"pone.0340985.ref011","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1161\/01.CIR.91.5.1588","article-title":"Chronic rapid atrial pacing. structural, functional, and electrophysiological characteristics of a new model of sustained atrial fibrillation","volume":"91","author":"CA Morillo","year":"1995","journal-title":"Circulation"},{"issue":"1","key":"pone.0340985.ref012","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/imi.0000000000000230","article-title":"A simple porcine model of inducible sustained atrial fibrillation","volume":"11","author":"AM Lee","year":"2016","journal-title":"Innovations (Phila)"},{"issue":"1","key":"pone.0340985.ref013","doi-asserted-by":"crossref","first-page":"3698","DOI":"10.1038\/s41598-022-07611-8","article-title":"Free-breathing gradient recalled echo-based CMR in a swine heart failure model","volume":"12","author":"CC Morris","year":"2022","journal-title":"Sci Rep"},{"issue":"1","key":"pone.0340985.ref014","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1038\/s42003-023-05564-w","article-title":"Biologically derived epicardial patch induces macrophage mediated pathophysiologic repair in chronically infarcted swine hearts","volume":"6","author":"JJ Lancaster","year":"2023","journal-title":"Commun Biol"},{"issue":"6","key":"pone.0340985.ref015","doi-asserted-by":"crossref","first-page":"662","DOI":"10.30802\/AALAS-JAALAS-24-000017","article-title":"COVID-19 pandemic effects on the activity levels of yucatan mini-swine (Sus scrofa domesticus)","volume":"63","author":"NE Barton","year":"2024","journal-title":"J Am Assoc Lab Anim Sci"},{"issue":"6","key":"pone.0340985.ref016","article-title":"Regional left ventricular wall stress postmyocardial infarction with magnetic resonance imaging in swine","volume":"328","author":"J Ref","year":"2025","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"pone.0340985.ref017","article-title":"Development of a Customizable Pacing Protocol to Induce Persistent Atrial Fibrillation in Swine","author":"F Bravo","year":"2025","journal-title":"PLOS One"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0340985","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T18:32:40Z","timestamp":1770229960000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0340985"}},"subtitle":[],"editor":[{"given":"Kamal","family":"Sharma","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,2,4]]},"references-count":17,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0340985","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,4]]}}}