{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T18:41:16Z","timestamp":1761676876237,"version":"build-2065373602"},"reference-count":37,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T00:00:00Z","timestamp":1586908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002460","name":"Chung-Ang University","doi-asserted-by":"publisher","award":["Research Grants in 2020"],"award-info":[{"award-number":["Research Grants in 2020"]}],"id":[{"id":"10.13039\/501100002460","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The investigation of the potential association between ischemic stroke and subclinical atrial fibrillation (SCAF) is important for secondary prevention. We aimed to determine whether SCAF can be predicted by atrial substrate measurement with P wave signal-averaged electrocardiography (SAECG). We recruited 125 consecutive patients with embolic stroke of undetermined source (ESUS) and 125 patients with paroxysmal atrial fibrillation as controls. All participants underwent P wave SAECG at baseline, and patients with ESUS were followed up with Holter monitoring and electrocardiography at baseline, 3, 6, and 12 months after discharge and every 6 months thereafter. In the ESUS group, 32 (25.6%) patients were diagnosed with SCAF during follow-up. There were no significant differences between the groups regarding atrial substrate. P wave duration (PWD) was a significant predictor of SCAF. Stroke recurrence occurred in 22 patients (17.6%), and prolonged PWD (\u2265 135 ms) predicted stroke recurrence more robustly than SCAF detection. In ESUS patients, PWD can be a useful biomarker to predict SCAF and to identify patients who are more likely to have a recurrent embolic stroke associated with an atrial cardiopathy. Further research is needed for supporting the utility and applicability of PWD.<\/jats:p>","DOI":"10.3390\/jcm9041134","type":"journal-article","created":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T09:19:50Z","timestamp":1586942390000},"page":"1134","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Usefulness of P Wave Duration in Embolic Stroke of Undetermined Source"],"prefix":"10.3390","volume":"9","author":[{"given":"Moonki","family":"Jung","sequence":"first","affiliation":[{"name":"Cardiovascular &amp; Arrhythmia Center, Chung-Ang University Hospital, Chung-Ang University, Seoul 06973, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1854-9312","authenticated-orcid":false,"given":"Jin-Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do 15355, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ju Hyeon","family":"Song","sequence":"additional","affiliation":[{"name":"Cardiovascular &amp; Arrhythmia Center, Chung-Ang University Hospital, Chung-Ang University, Seoul 06973, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeong-Min","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Chung-Ang University Hospital, Chung-Ang University, Seoul 06973, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwang-Yeol","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurology, Chung-Ang University Hospital, Chung-Ang University, Seoul 06973, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wang-Soo","family":"Lee","sequence":"additional","affiliation":[{"name":"Cardiovascular &amp; Arrhythmia Center, Chung-Ang University Hospital, Chung-Ang University, Seoul 06973, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang Wook","family":"Kim","sequence":"additional","affiliation":[{"name":"Cardiovascular &amp; Arrhythmia Center, Chung-Ang University Hospital, Chung-Ang University, Seoul 06973, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory YH","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool L69 3BX, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3408-6899","authenticated-orcid":false,"given":"Seung Yong","family":"Shin","sequence":"additional","affiliation":[{"name":"Cardiovascular &amp; Arrhythmia Center, Chung-Ang University Hospital, Chung-Ang University, Seoul 06973, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1161\/STROKEAHA.114.007240","article-title":"Embolic Strokes of Undetermined Source in the Athens Stroke Registry","volume":"46","author":"Ntaios","year":"2015","journal-title":"Stroke"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1056\/NEJMoa1105575","article-title":"Subclinical Atrial Fibrillation and the Risk of Stroke","volume":"366","author":"Healey","year":"2012","journal-title":"New Engl. 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