{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T09:20:46Z","timestamp":1791537646492,"version":"4.3.4"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":492,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T00:00:00Z","timestamp":1717977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) and heart failure (HF) affect each other and are often co-morbid. The fact that HF development is not uncommon even after ablation suggests that we need a deeper understanding of the pathology of these conditions. Atrial myocardial degeneration is an underlying factor in AF patients and may be associated with HF development after ablation. This study aimed to investigate the impact of low-voltage areas (LVAs) on HF prognosis after AF ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This observational study included 1481 consecutive patients undergoing initial ablation for AF. Left atrial LVAs were defined as regions with a bipolar peak-to-peak voltage of &amp;lt;0.50 mV. Patients were divided into three groups: no LVA (LVA size indexed to body surface area &amp;lt;3 cm2\/m2, n = 1129), small LVA (3\u201310 cm2\/m2, n = 217), and extensive LVA (\u226510 cm2\/m2, n = 135). A composite endpoint of HF hospitalization or death occurred more frequently in patients with larger LVAs (3.3% vs. 6.5% vs. 13.3%, P &amp;lt; 0.0001) during the 3-year follow up period. The extent of LVAs was independently related to the risk of the composite endpoint with an adjusted hazard ratio of 1.55 (95% confidence interval, 1.16\u20132.10) for each additional step of LVA classification (P = 0.003).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LVA presence and its extent were associated with frequent HF hospitalization and death. Underlying atrial myopathy appears to define a poor HF prognosis after AF ablation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14878","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T03:44:18Z","timestamp":1717991058000},"page":"3065-3074","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Left Atrial Low Voltage Areas and Heart Failure in Patients with Atrial Fibrillation: Implication of the Atrial Myopathy"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5566-466X","authenticated-orcid":false,"given":"Masaharu","family":"Masuda","sequence":"first","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center , Amagasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Uematsu","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center , Amagasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center , Amagasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayako","family":"Sugino","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center , Amagasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka","family":"Ooka","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center , Amagasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kudo","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center , Amagasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subaru","family":"Fujii","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center , Amagasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center , Amagasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Ishihara","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center , Amagasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyonori","family":"Nanto","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center , Amagasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Tsujimura","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center , Amagasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Hata","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center , Amagasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sho","family":"Nakao","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center , Amagasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiaki","family":"Mano","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center , Amagasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,6,10]]},"reference":[{"key":"2026012113150742400_ehf214878-bib-0001","doi-asserted-by":"publisher","first-page":"2920","DOI":"10.1161\/01.CIR.0000072767.89944.6E","article-title":"Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham heart study","volume":"107","author":"Wang","year":"2003","journal-title":"Circulation"},{"key":"2026012113150742400_ehf214878-bib-0002","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1093\/europace\/euaa217","article-title":"Atrial fibrillation ablation in heart failure: what do we know? 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