{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T14:17:00Z","timestamp":1780755420929,"version":"3.54.1"},"reference-count":26,"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":467,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T00:00:00Z","timestamp":1720137600000},"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>Catheter ablation (CA) of atrial fibrillation (AF) improves left ventricular ejection fraction (LVEF) in patients with heart failure with reduced ejection fraction (HFrEF). The impact of ST-segment depression before CA on LVEF recovery and clinical outcomes remains unknown. In the present study, we aimed to investigate the relationship between ST-segment depression during AF rhythm before CA and improvement in the LVEF and clinical outcomes in persistent atrial fibrillation (PerAF) patients with HFrEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>The present study included 122 PerAF patients (male; 98 patients, 80%, mean age: 69 [56, 76] years) from the Osaka Rosai Atrial Fibrillation ablation (ORAF) registry who had LVEF &amp;lt; 50% and underwent an initial ablation. The patients who underwent percutaneous coronary intervention or coronary artery bypass grafting within the past 1 month were not included in the enrolled patients. We assigned the patients based on the presence of ST-segment depression before CA during AF rhythm and evaluated improvement in the LVEF (LVEF \u2265 15%) 1 year after CA and the relationship between ST-segment depression and heart failure (HF) hospitalization\/major adverse cardiovascular events (MACE), which are defined as a composite of HF hospitalization, cardiovascular death, hospitalization due to coronary artery disease, ventricular arrhythmia requiring hospitalization and stroke. The percentage of patients with improvement in the LVEF 1 year after CA was significantly lower in the patients with ST-segment depression than those without (58.6% vs. 79.7%, P = 0.012). Multiple regression analysis showed ST-segment depression was independently and significantly associated with improvement in the LVEF 1 year after CA (HR: 0.35; 95% CI: 0.129\u20130.928, P = 0.035). Kaplan\u2013Meier analysis showed that the patients with ST-segment depression significantly had higher risk of HF hospitalization and MACE than those without (log rank P = 0.022 and log rank P = 0.002, respectively). Multivariable Cox proportional hazards analysis showed that ST-segment depression was independently and significantly associated with a higher risk of MACE (HR: 2.82; 95% CI: 1.210\u20136.584, P = 0.016).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ST-segment depression before CA during AF rhythm was useful prognostic predictor of improvement in the LVEF and clinical outcomes including HF hospitalization and MACE in PerAF patients with HFrEF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14946","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T06:20:12Z","timestamp":1720160412000},"page":"3368-3377","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["ST-Segment Depression and Left Ventricular Systolic Function Recovery Post-Atrial Fibrillation Ablation in Heart Failure"],"prefix":"10.1093","volume":"11","author":[{"given":"Masamichi","family":"Yano","sequence":"first","affiliation":[{"name":"Division of Cardiology, Osaka Rosai Hospital , Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Egami","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Osaka Rosai Hospital , Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shodai","family":"Kawanami","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Osaka Rosai Hospital , Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Ukita","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Osaka Rosai Hospital , Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akito","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Osaka Rosai Hospital , Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Yasumoto","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Osaka Rosai Hospital , Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Tsuda","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Osaka Rosai Hospital , Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naotaka","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Osaka Rosai Hospital , Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuharu","family":"Matsunaga-Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Osaka Rosai Hospital , Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0309-7023","authenticated-orcid":false,"given":"Masami","family":"Nishino","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Osaka Rosai Hospital , Osaka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,7,5]]},"reference":[{"key":"2026012113152410900_ehf214946-bib-0001","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/j.ahj.2013.12.001","article-title":"Associations between atrial fibrillation and early outcomes of patients with heart failure and reduced or preserved ejection fraction","volume":"167","author":"Eapen","year":"2014","journal-title":"Am Heart J"},{"key":"2026012113152410900_ehf214946-bib-0002","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1016\/s0735-1097(98)00297-6","article-title":"Atrial fibrillation is associated with an increased risk for mortality and heart failure progression in patients with asymptomatic and symptomatic left ventricular systolic dysfunction: a retrospective analysis of the SOLVD trials. 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