Heart rhythm最新文献

{"title":"Author’s reply—Defibrillation pad positioning in refractory ventricular arrhythmias","authors":"Anna G. Rosenblatt MD, Mark S. Link MD, FHRS","doi":"10.1016/j.hrthm.2025.07.013","DOIUrl":"10.1016/j.hrthm.2025.07.013","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Page e1046"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a universal monitoring system (“third party”) on outcomes of ICD patients: A nationwide study","authors":"Niraj Varma MD, PhD ,&nbsp;Eloi Marijon MD, PhD ,&nbsp;Éric Vicaut MD, PhD ,&nbsp;Serge Boveda MD, PhD ,&nbsp;Alexandre Abraham PhD ,&nbsp;Issam Ibnouhsein PhD ,&nbsp;Arnaud Rosier MD, PhD ,&nbsp;Pascal Defaye MD ,&nbsp;Jagmeet P. Singh MD, PhD","doi":"10.1016/j.hrthm.2024.11.029","DOIUrl":"10.1016/j.hrthm.2024.11.029","url":null,"abstract":"<div><h3>Background</h3><div>Adherence to recommended follow-up schedules for remote monitoring (RM) of patients with implantable cardioverter-defibrillators (ICDs) is inconsistent, which may influence clinical outcomes. Systematic organization through a “third-party” universal monitoring system (UMS) may be beneficial.</div></div><div><h3>Objective</h3><div>We aimed to evaluate the clinical impact of RM and any incremental benefit of UMS vs conventional RM.</div></div><div><h3>Methods</h3><div><span>In the comprehensive French nationwide health database, we identified 69,394 ICD patients (67.9 ± 13.4 years; male, 77.5%; 34.9% defibrillator with cardiac resynchronization therapy) with clinical data. Hospitalizations and survival were assessed for 1 year (2019). Patients were classified by RM status (no-RM and RM), then RM separated further by follow-up method (conventional manufacturer-specific RM or UMS). Adjusted annual </span>mortality rates and hospitalizations (all-cause, heart failure, number, and duration) were compared in no-RM vs RM, then conventional RM vs UMS.</div></div><div><h3>Results</h3><div>Mortality rate was reduced in RM vs no-RM (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.95–0.97; <em>P</em> &lt; .001). In RM, all-cause hospitalizations increased in number but their cumulative duration diminished (HR, 0.98; 95% CI, 0.98–0.99; <em>P</em> &lt; .001). Compared with conventional RM, UMS was associated with reduced rates of mortality (HR, 0.74; 95% CI, 0.73–0.77; <em>P</em> &lt; .001), all-cause and heart failure hospitalizations (HR, 0.96; 95% CI, 0.95–0.97; <em>P</em> &lt; .001), and hospital stay duration (HR, 0.96; 95% CI, 0.95–0.97; <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>RM was associated with improved survival in ICD recipients. Importantly, we found that use of UMS was associated with additional improvement in clinical outcomes, including survival and hospitalizations. These observations point to organizational challenges in conventionally managed RM that can be mitigated by a universal monitoring platform.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2661-2668"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consequences of electrocardiography screening for prolonged QTc in neonates—A systematic review","authors":"Anna Leppänen BM ,&nbsp;Emmi Helle MD, PhD ,&nbsp;Ilari Kuitunen MD, PhD","doi":"10.1016/j.hrthm.2025.02.045","DOIUrl":"10.1016/j.hrthm.2025.02.045","url":null,"abstract":"<div><h3>Background</h3><div>An ongoing discussion has been the effectiveness of neonatal electrocardiography (ECG) screening for long QT syndrome (LQTS).</div></div><div><h3>Objective</h3><div>The aim of this systematic review was to assess the consequences of ECG screening for prolonged corrected QT (QTc) interval in infants younger than 1 month.</div></div><div><h3>Methods</h3><div>We searched the PubMed, Scopus, and Web of Science databases in June 2024. The incidence rates of prolonged QTc, defined as &gt;450 ms, were calculated per 1000 neonates. Prolonged QTc cases, including normalization during follow-up, LQTS diagnosis, and sudden infant death syndrome (SIDS), were analyzed.</div></div><div><h3>Results</h3><div>Eight studies were included. Five studies using a cutoff QTc &gt;450 ms reported incidences ranging from 5 (95% confidence interval [CI], 5–6) to 79 (CI, 60–102) per 1000 neonates. Six studies with a cutoff of &gt;460 ms reported incidences ranging from 1 (CI, 1–2) to 53 (CI, 50–57). Five studies (cutoff QTc &gt;470 ms) had incidences varying from 1 (CI, 0–1) to 28 (CI, 21–35). In 6 studies, QTc normalization during follow-up occurred in 57.1% to 95.2% of neonates with prolonged QTc. The diagnosis of LQTS was reported in 4 studies, with 21 of 51,817 (0.04%) neonates later diagnosed with LQTS. Two studies reported SIDS outcomes, finding prolonged QTc in 8 of 24 and 3 of 3 SIDS cases.</div></div><div><h3>Conclusion</h3><div>The incidence of prolonged QTc varied widely across studies. Only a small proportion of neonates with prolonged QTc were diagnosed with LQTS during follow-up. Further research with standardized study factors and comprehensive genetic analysis is needed to determine the utility of and indications for neonatal ECG screening.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2689-2694"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and genetic variant re-analysis among pediatric probands undergoing genetic testing for arrhythmia syndromes","authors":"Sara B. Stephens PhD, MPH ,&nbsp;Christopher W. Follansbee MD ,&nbsp;Tyler Novy MD ,&nbsp;Taylor S. Howard MD ,&nbsp;Tam Dan Pham MD ,&nbsp;Anna M. Lang BS ,&nbsp;Taylor Beecroft-Dawson MS, CGC ,&nbsp;Abigail Yesso MS, CGC ,&nbsp;Emily Soludczyk MS, CGC ,&nbsp;Wenxin Zou PhD ,&nbsp;Yuxin Fan MD, PhD ,&nbsp;Jeffrey J. Kim MD, FHRS ,&nbsp;Santiago O. Valdes MD ,&nbsp;Christina Y. Miyake MD, MS, MPH","doi":"10.1016/j.hrthm.2025.05.016","DOIUrl":"10.1016/j.hrthm.2025.05.016","url":null,"abstract":"<div><h3>Background</h3><div>Despite increases in genetic testing, longitudinal data regarding changes in diagnostic yield and variant reclassification for inherited arrhythmia syndromes are limited.</div></div><div><h3>Objective</h3><div>Determine longitudinal changes in diagnostic yield and variant classification.</div></div><div><h3>Methods</h3><div><span><span>Single-center retrospective study of probands &lt;18 years undergoing genetic testing for suspected inherited cardiac conditions associated with arrhythmias, 2007 to 2018. Variants were classified as diagnostic (pathogenic/likely pathogenic), non-diagnostic (benign/likely benign [B/LB]), or variants of uncertain significance (VUS). Variant reclassification was performed in October 2023 using VarSome and American College of </span>Medical Genetics criteria. We evaluated results by era (early 2007–2013 vs. later 2014–2018, coinciding with Sanger and next-generation sequencing, respectively) and by likelihood of disease based on </span>clinical evaluation.</div></div><div><h3>Results</h3><div>Of 306 probands, initial testing was 23.2% diagnostic, 55.6% non-diagnostic (33.7% no variant, 21.9% B/LB), and 21.2% VUS. When comparing eras, diagnostic yield decreased (34.1%–15.3%), VUS increased (9.3%–29.9%), and non-diagnostic remained similar (55% to 57%). Variants for 22.7% (46/203) of probands with ≥1 variant changed: 9.9% of diagnostic variants (7/71) downgraded to VUS or non-diagnostic, and 60.0% of VUS changed (23.1% upgraded, 36.9% downgraded). B/LB variants did not change. Probands with higher disease likelihood had 6-times the odds of diagnostic results compared to lower disease likelihood, regardless of era (odds ratio 6.3, 95% confidence interval 3.2–12.4, <em>P</em> &lt; .0001).</div></div><div><h3>Conclusion</h3><div>Variant reclassification led to changes in 23% of probands, both downgrading and upgrading status, even among probands initially thought to be pathogenic. When comparing later to earlier eras, VUS variants increased while diagnostic yield decreased. Findings support the need for variant re-interpretation and periodic reclassification over time.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e931-e938"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right atrial reverse remodeling after pulmonary vein isolation: Analyzing changes in volume and function using cardiac magnetic resonance imaging","authors":"Nikki van Pouderoijen MSc,&nbsp;Luuk H.G.A. Hopman PhD,&nbsp;Leontine E. Wentrup MSc,&nbsp;Joris R. de Groot MD, PhD,&nbsp;Michiel J.B. Kemme MD, PhD,&nbsp;Cornelis P. Allaart MD, PhD ,&nbsp;Marco J.W. Götte MD, PhD","doi":"10.1016/j.hrthm.2025.03.1976","DOIUrl":"10.1016/j.hrthm.2025.03.1976","url":null,"abstract":"<div><h3>Background</h3><div>Successful pulmonary vein isolation (PVI) promotes left atrial (LA) reverse remodeling, but its effect on right atrial (RA) remodeling remains unclear.</div></div><div><h3>Objective</h3><div>The purpose of this study was to assess the impact of radiofrequency (RF) PVI on RA volumes and function in patients with atrial fibrillation by using cardiac magnetic resonance imaging.</div></div><div><h3>Methods</h3><div>Forty-three patients with atrial fibrillation (32 (74.4%) males; mean age 61±7 years) undergoing first RF PVI, without atrial flutter ablation, underwent 3 cardiac magnetic resonance scans: pre-PVI, early (&lt;72 hours) post-PVI, and 3 months post-PVI. Indexed atrial volumes (RA maximal/minimal volume index and LA maximal/minimal volume index) and function were derived from 2- and 4-chamber cine images, with longitudinal atrial strain analyzed using feature tracking.</div></div><div><h3>Results</h3><div>Early post-PVI, RA minimal volume index significantly decreased (from 28.7±10.3 to 26.0±9.9 mL/m²; <em>P</em>=.03) while RA emptying fraction significantly increased (from 37.3%±11.5% to 41.7%±10.1%; <em>P</em>=.03). At 3 months, both RA minimal volume index and RA maximal volume index showed further significant reductions compared with baseline (from 28.7±10.3 to 24.8±8.8 mL/m²; <em>P</em>=.002 and from 45.2±11.8 to 40.3±11.9 mL/m²; <em>P</em>&lt;.001, respectively). During this period, RA functional improvement persisted, as evidenced by RA reservoir and contractile strain (from 16.2%±4.1% to 18.9%±3.6%; <em>P</em>=.003 and from 6.6%±2.6% to 8.3%±2.8%; <em>P</em>=.005, respectively). LA volumes remained unchanged early post-PVI, but at 3 months, LA maximal volume index significantly decreased compared with baseline (from 46.1±13.0 to 39.1±11.3 mL/m²; <em>P</em>&lt;.001). LA function, demonstrated by reservoir and contractile strain, was significantly diminished early post-PVI, which persisted at 3 months compared with baseline (from 18.6%±4.0% to 17.0%±3.4%; <em>P</em>=.04 and from 8.5%±3.0% to 6.9%±2.4%; <em>P</em>&lt;.01, respectively).</div></div><div><h3>Conclusion</h3><div>This study demonstrates that RF PVI results in reverse biatrial remodeling, with significant reductions observed in RA and LA volumes. RA function showed a significant improvement post-PVI, while LA function demonstrated persistent impairment at 3 months, possibly because of LA ablation scarring.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2543-2550"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Right-variant” atypical atrioventricular nodal reentrant tachycardia with a bystander, concealed nodofascicular/nodoventricular bypass tract","authors":"Taihei Itoh MD ,&nbsp;Shogo Hamaura MD ,&nbsp;Yuichi Toyama MD ,&nbsp;Yuji Ishida MD ,&nbsp;Masaomi Kimura MD ,&nbsp;Hirofumi Tomita MD","doi":"10.1016/j.hrthm.2025.06.028","DOIUrl":"10.1016/j.hrthm.2025.06.028","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e1022-e1023"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Top stories: Cardiac implantable electronic devices","authors":"Sana M. Al-Khatib MD, MHS, FHRS","doi":"10.1016/j.hrthm.2025.06.034","DOIUrl":"10.1016/j.hrthm.2025.06.034","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2733-2734"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of photoplethysmography-based rhythm monitoring after atrial fibrillation ablation using a smartphone application: DIGITOTAL study","authors":"Henri Gruwez MD, PhD ,&nbsp;Hugo Van Herendael MD ,&nbsp;Seppe Maris MSc ,&nbsp;Sebastiaan Dhont MD ,&nbsp;Evelyne Meekers MD ,&nbsp;Liesbeth Bruckers MSc, PhD ,&nbsp;Femke Wouters MSc ,&nbsp;Maximo Rivero-Ayerza MD ,&nbsp;Dieter Nuyens MD, PhD ,&nbsp;Pieter Vandervoort MD, PhD ,&nbsp;Peter Haemers MD, PhD ,&nbsp;Laurent Pison MD, PhD","doi":"10.1016/j.hrthm.2024.11.026","DOIUrl":"10.1016/j.hrthm.2024.11.026","url":null,"abstract":"<div><h3>Background</h3><div>Recurrence after atrial fibrillation<span> (AF) ablation is frequent. Monitoring with long-term electrocardiograms (ECGs) is constrained by limited monitoring time, measurement dispersion, and cost. Selected photoplethysmography (PPG) smartphone applications have demonstrated excellent accuracy for AF detection and could mitigate these limitations.</span></div></div><div><h3>Objective</h3><div>We aimed to compare the effectiveness of digital follow-up using a PPG-based smartphone application against conventional ECG-based follow-up for the detection of atrial arrhythmia recurrence after ablation.</div></div><div><h3>Methods</h3><div>Patients undergoing AF ablation were consecutively enrolled and monitored by a 24-hour ECG at 3, 6, and 12 months on top of the ECGs conducted for clinical indications (conventional follow-up). In addition, patients were instructed to perform PPG measurements twice daily or whenever symptoms were perceived during the course of 1 year (digital follow-up).</div></div><div><h3>Results</h3><div><span>In total, 96 patients (69% male; mean age, 64 ± 9 years) performed 39,895 PPG measurements. The compliance rate (number performed/prescribed) was 92.6% for ECGs and 78.2% for PPG recordings. After 1 year of follow-up, atrial arrhythmia recurrence was detected in 17.7% of patients by conventional follow-up and in 38.5% of patients by digital follow-up (odds ratio, 3.4; 95% confidence interval [CI], 1.7–7.1). The CI lower limit exceeded the predefined noninferiority margin (</span><em>P</em> for noninferiority &gt; .001). Hence, superiority was tested (<em>P</em> for superiority = .001). The negative predictive value of digital follow-up for atrial arrhythmia detected with conventional follow-up was 98.3% (95% CI, 90.9%–99.9%).</div></div><div><h3>Conclusion</h3><div>Digital rhythm follow-up using a smartphone application with PPG was noninferior to conventional follow-up in detecting atrial arrhythmia recurrence between 3 and 12 months after ablation. Moreover, digital follow-up significantly increased the detection of atrial arrhythmia.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2570-2578"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of ultrarapid genomic testing for management of malignant pediatric arrhythmia","authors":"Yuji Doi MD ,&nbsp;Andreas Pflaumer MD, FHRS ,&nbsp;Ivan Macciocca BSc, GD (Gen Couns), FHGSA ,&nbsp;Vanessa Connell RN ,&nbsp;Sebastain Lunke PhD ,&nbsp;Zornitza Stark BM, BCh DM ,&nbsp;Andrew Davis MBBS, MD, FHRS","doi":"10.1016/j.hrthm.2025.05.037","DOIUrl":"10.1016/j.hrthm.2025.05.037","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e1034-e1036"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke risks in women vs men in Asian patients with atrial fibrillation: A temporal trend analysis and a comparison of the CHA2DS2-VASc and CHA2DS2-VA stroke risk stratification scores","authors":"Wen-Han Cheng MD ,&nbsp;Yi-Hsin Chan MD ,&nbsp;Ling Kuo MD ,&nbsp;Jo-Nan Liao MD ,&nbsp;Chih-Min Liu MD ,&nbsp;Shih-Ann Chen MD ,&nbsp;Gregory Y.H. Lip MD ,&nbsp;Tze-Fan Chao MD","doi":"10.1016/j.hrthm.2025.05.067","DOIUrl":"10.1016/j.hrthm.2025.05.067","url":null,"abstract":"<div><h3>Background</h3><div><span>The 2024 European guidelines for atrial fibrillation (AF) recommended the use of the sex-less CHA</span>₂DS₂-VASc score (ie, CHA₂DS₂-VA) for stroke risk assessment, but this has been less well-validated in Asian cohorts.</div></div><div><h3>Objective</h3><div><span>We aimed to perform a temporal analysis of stroke risks in women vs men with AF in Taiwan and to compare the performance of CHA</span>₂DS₂-VASc vs CHA₂DS₂-VA scores.</div></div><div><h3>Methods</h3><div>We used Taiwan’s National Health Database (2000–2021) to compare CHA₂DS₂-VASc and CHA₂DS₂-VA scores by 2-year intervals, assessing performance with net reclassification index, integrated discrimination improvement, and C-statistics.</div></div><div><h3>Results</h3><div><span>We analyzed 495,569 newly diagnosed, non-anticoagulated patients with AF (44% women). Across calendar years, women consistently had higher ischemic stroke risks than men (incidence rate ratio [IRR] 1.13–1.26, all </span><em>P</em> &lt; .05). Among those with CHA₂DS₂-VA scores of 0–1, women had a lower stroke risk (score 0: IRR 0.81; score 1: IRR 0.88, both <em>P</em> &lt; .001). For scores 2–8, stroke risk was higher in women (IRR 1.04–1.11, all <em>P</em> &lt; .05). CHA₂DS₂-VASc significantly outperformed CHA₂DS₂-VA in net reclassification index from 2000 to 2021 and in integrated discrimination improvement from 2000 to 2015. C-statistics were slightly higher for CHA₂DS₂-VASc from 2000 to 2013 (<em>P</em> &lt; .05), but not significantly different after 2014 (<em>P</em> &gt; .05), suggesting comparable performance of the 2 scores in more recent years.</div></div><div><h3>Conclusion</h3><div>Women with AF have a higher stroke risk than men only in high CHA₂DS₂-VA score categories, suggesting female sex is more likely to be a risk modifier of stroke in AF. Retaining the female sex as a component of the CHA₂DS₂-VASc score may improve the net reclassification for stroke events in Asian patients with AF.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2515-2523"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}