{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T09:10:21Z","timestamp":1778490621392,"version":"3.51.4"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4ts-Herzzentrum Freiburg - Bad Krozingen GmbH"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Atrial cardiomyopathy (AtCM) represents an important substrate underlying atrial fibrillation (AF), increased arrhythmia recurrence after catheter ablation, and other adverse outcomes. Several non-invasive markers have been proposed as surrogates of AtCM, but their comparative performance and clinical relevance remain insufficiently validated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective study, 200 patients undergoing first-time catheter ablation for symptomatic AF were included. All patients underwent high-density left atrial electroanatomical mapping, which served as reference standard for AtCM assessment based on the extent of left atrial low-voltage substrate (LA-LVS). Non-invasive AtCM markers derived from 12-lead electrocardiography (ECG), transthoracic echocardiography, and blood-based biomarkers were systematically compared with LA-LVS extent and their predictive value for arrhythmia recurrence during follow-up was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among non-invasive AtCM markers, amplified P-wave duration (PWD) and P-wave amplitude in lead I showed the strongest association with LA-LVS extent. In multivariable logistic regression analysis, prolonged amplified PWD (\u2265\u2009150\u00a0ms) was independently associated with relevant AtCM (odds ratio 11.46, 95% confidence interval 2.27\u201357.90,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). During a median follow-up of 277\u00a0days, arrhythmia recurrence occurred in 21.9% of patients. In Cox regression analysis, amplified PWD\u2009\u2265\u2009150\u00a0ms was the only non-invasive AtCM marker independently associated with arrhythmia recurrence (hazard ratio 2.01, 95% confidence interval 1.07\u20133.78,\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.031).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients undergoing first-time AF ablation, amplified PWD emerged as the most robust non-invasive marker of AtCM, independently associated with invasively assessed LA-LVS and arrhythmia recurrence. Advanced surface ECG analysis may represent a practical and widely applicable tool for AtCM-associated risk stratification in routine clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-026-02908-4","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T07:06:05Z","timestamp":1774854365000},"page":"1027-1041","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Head-to-head\u00a0comparison of non-invasive markers of atrial cardiomyopathy and their association with arrhythmia recurrence after atrial fibrillation ablation"],"prefix":"10.1007","volume":"115","author":[{"given":"Laura","family":"Dippel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis","family":"Fedorov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir","family":"Jadidi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Westermann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heiko","family":"Lehrmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Arentz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3674-790X","authenticated-orcid":false,"given":"Martin","family":"Eichenlaub","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"issue":"2","key":"2908_CR1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf793","volume":"47","author":"OB Vad","year":"2025","unstructured":"Vad OB, Vreeswijk N, Yassin AS et al (2025) Atrial cardiomyopathy: markers and outcomes. 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