English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background:  The  ZFHX3  gene (16q22) is the second most highly associated gene with atrial fibrillation (AF) and is related to inflammation and fibrosis. We hypothesized that  ZFHX3  is associated with extra-pulmonary vein (PV) triggers, left atrial (LA) structural remodeling, and poor rhythm outcomes of AF catheter ablation (AFCA).   Methods:  We included 1,782 patients who underwent a  de novo  AFCA (73.5% male, 59.4 ± 10.8 years old, 65.9% paroxysmal AF) and genome-wide association study and divided them into discovery ( n  = 891) and replication cohorts ( n  = 891). All included patients underwent isoproterenol provocation tests and LA voltage mapping. We analyzed the  ZFHX3 , extra-PV trigger-related factors, and rhythm outcomes.   Result:  Among 14 single-nucleotide polymorphisms (SNPs) of  ZFHX3 , rs13336412, rs61208973, rs2106259, rs12927436, and rs1858801 were associated with extra-PV triggers. In the overall patient group, extra-PV triggers were independently associated with the  ZFHX3  polygenic risk score (PRS) (OR 1.65 [1.22–2.22],  p  = 0.001, model 1) and a low LA voltage (OR 0.74 [0.56–0.97],  p  = 0.029, model 2). During 49.9 ± 40.3 months of follow-up, clinical recurrence of AF was significantly higher in patients with extra-PV triggers (Log-rank  p  &amp;lt; 0.001, HR 1.89 [1.49–2.39],  p  &amp;lt; 0.001, model 1), large LA dimensions (Log-rank  p  &amp;lt; 0.001, HR 1.03 [1.01–1.05],  p  = 0.002, model 2), and low LA voltages (Log-rank  p  &amp;lt; 0.001, HR 0.73 [0.61–0.86],  p  &amp;lt; 0.001, model 2) but not the  ZFHX3  PRS (Log-rank  p  = 0.819).   Conclusion:  The extra-PV triggers had significant associations with both  ZFHX3  genetic polymorphisms and acquired LA remodeling. Although extra-PV triggers were an independent predictor of AF recurrence after AFCA, the studied AF risk SNPs intronic in  ZFHX3  were not associated with AF recurrence.

Association of ZFHX3 Genetic Polymorphisms and Extra-Pulmonary Vein Triggers in Patients With Atrial Fibrillation Who Underwent Catheter Ablation