{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T02:05:37Z","timestamp":1794017137733,"version":"4.8.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T00:00:00Z","timestamp":1631836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Data regarding the efficacy of catheter ablation in heart failure patients with severely dilated left atrium and reduced left ventricular ejection fraction (LVEF) are scanty. We sought to assess the efficacy of catheter ablation in patients with reduced LVEF and severe left atrial (LA) enlargement, and to compare it to those patients with preserved left ventricular function and equally dilated left atrium.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Three patient groups with paroxysmal or persistent atrial fibrillation (AF) undergoing a first pulmonary vein isolation (PVI) were considered: Group 1 included patients with normal or mildly abnormal LA volume (\u226441 mL\/m2) and normal LVEF; Group 2 included patients with severe LA enlargement (&amp;gt;48\u2009mL\/m2) and normal LVEF; and Group 3 included patients with severe LA enlargement and reduced LVEF. Time to event analysis was used to investigate AF recurrences. The study cohort includes 439 patients; Group 3 had a higher prevalence of cardiovascular risk factors. LA enlargement was associated with a two-fold in risk of AF recurrence, on the contrary only a smaller non-significant increase of 30% was shown with the further addition of LVEF reduction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The long-term outcome of patients with severe LA dilatation and reduced LVEF is comparable to those with severe LA enlargement but preserved LVEF. Long-term efficacy of PVI is certainly affected by the enlargement of the left atrium, but less so by the addition of a reduced LVEF. CA remains the best strategy for rhythm control both in paroxysmal and persistent AF in this subgroup of patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euab213","type":"journal-article","created":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T19:12:16Z","timestamp":1628277136000},"page":"1751-1756","source":"Crossref","is-referenced-by-count":16,"title":["Long-term outcome of catheter ablation for atrial fibrillation in patients with severe left atrial enlargement and reduced left ventricular ejection fraction"],"prefix":"10.1093","volume":"23","author":[{"given":"Andrea","family":"Demarchi","sequence":"first","affiliation":[{"name":"Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Neumann","sequence":"additional","affiliation":[{"name":"Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Rordorf","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Conte","sequence":"additional","affiliation":[{"name":"Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Sanzo","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tardu","family":"\u00d6zkartal","sequence":"additional","affiliation":[{"name":"Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Savastano","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Regoli","sequence":"additional","affiliation":[{"name":"Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland"},{"name":"Department of Cardiology, Ospedale San Giovanni, Via Ospedale 12, 6500 Bellinzona, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Vicentini","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luce","family":"Caputo","sequence":"additional","affiliation":[{"name":"Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Klersy","sequence":"additional","affiliation":[{"name":"Service of Clinical Epidemiology & Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Petracci","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Piciacchia","sequence":"additional","affiliation":[{"name":"Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolie","family":"Bruno","sequence":"additional","affiliation":[{"name":"Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Baldi","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy"},{"name":"Department of Molecular Medicine, Section of Cardiology, University of Pavia, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabatino","family":"D\u2019Amore","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, Section of Cardiology, University of Pavia, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2116-6993","authenticated-orcid":false,"given":"Angelo","family":"Auricchio","sequence":"additional","affiliation":[{"name":"Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,17]]},"reference":[{"key":"2021110907011550700_euab213-B1","doi-asserted-by":"crossref","first-page":"40828","DOI":"10.1038\/srep40828","article-title":"Prediction of very late arrhythmia recurrence after radiofrequency catheter ablation of atrial fibrillation: the MB-LATER clinical score","volume":"7","author":"Mujovic","year":"2017","journal-title":"Sci Rep"},{"key":"2021110907011550700_euab213-B2","doi-asserted-by":"crossref","first-page":"f460","DOI":"10.1093\/europace\/euy043","article-title":"Development and validation of a risk score for predicting atrial fibrillation recurrence after a first catheter ablation procedure\u2014ATLAS score","volume":"20","author":"Mesquita","year":"2018","journal-title":"Europace"},{"key":"2021110907011550700_euab213-B3","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1136\/hrt.2010.215335","article-title":"Impact of left atrial fibrosis and left atrial size on the outcome of catheter ablation for atrial fibrillation","volume":"97","author":"Den Uijl","year":"2011","journal-title":"Heart"},{"key":"2021110907011550700_euab213-B4","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1093\/eurheartj\/ehm027","article-title":"Pre-procedural predictors of atrial fibrillation recurrence after circumferential pulmonary vein ablation","volume":"28","author":"Berruezo","year":"2007","journal-title":"Eur Heart J"},{"key":"2021110907011550700_euab213-B5","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1093\/europace\/euu013","article-title":"Predictors of recurrence after a repeat ablation procedure for paroxysmal atrial fibrillation: role of left atrial enlargement","volume":"16","author":"Tang","year":"2014","journal-title":"Europace"},{"key":"2021110907011550700_euab213-B6","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1253\/circj.CJ-19-0167","article-title":"U-shaped relationship between left atrium size on echocardiography and 1-year recurrence of atrial fibrillation after radiofrequency catheter ablation-prognostic value study","volume":"83","author":"Wang","year":"2019","journal-title":"Circ J"},{"key":"2021110907011550700_euab213-B7","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1093\/europace\/eur364","article-title":"Association between left atrial size and atrial fibrillation recurrence after single circumferential pulmonary vein isolation: a systematic review and meta-analysis of observational studies","volume":"14","author":"Zhuang","year":"2012","journal-title":"Europace"},{"key":"2021110907011550700_euab213-B8","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1016\/j.jacc.2017.08.041","article-title":"Catheter ablation versus medical rate control in atrial fibrillation and systolic dysfunction: the CAMERA-MRI study","volume":"70","author":"Prabhu","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2021110907011550700_euab213-B9","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1056\/NEJMoa1707855","article-title":"Catheter ablation for atrial fibrillation with heart failure","volume":"378","author":"Marrouche","year":"2018","journal-title":"N Engl J Med"},{"key":"2021110907011550700_euab213-B10","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1161\/CIRCULATIONAHA.115.019406","article-title":"Ablation versus amiodarone for treatment of persistent atrial fibrillation in patients with congestive heart failure and an implanted device: results from the AATAC multicenter randomized trial","volume":"133","author":"Di Biase","year":"2016","journal-title":"Circulation"},{"key":"2021110907011550700_euab213-B11","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur Heart J"},{"key":"2021110907011550700_euab213-B12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"key":"2021110907011550700_euab213-B13","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1002\/clc.23068","article-title":"Meta-analysis of randomized controlled trials on atrial fibrillation ablation in patients with heart failure with reduced ejection fraction","volume":"41","author":"Smer","year":"2018","journal-title":"Clin Cardiol"},{"key":"2021110907011550700_euab213-B14","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1016\/j.hlc.2018.10.022","article-title":"Catheter ablation versus medical therapy for atrial fibrillation in patients with heart failure: a meta-analysis of randomised controlled trials","volume":"28","author":"Virk","year":"2019","journal-title":"Heart Lung Circ"},{"key":"2021110907011550700_euab213-B15","doi-asserted-by":"crossref","first-page":"e008461","DOI":"10.1161\/CIRCEP.120.008461","article-title":"Impact of left ventricular function and heart failure symptoms on outcomes post ablation of atrial fibrillation in heart failure CASTLE-AF trial","volume":"13","author":"Sohns","year":"2020","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2021110907011550700_euab213-B16","doi-asserted-by":"crossref","first-page":"2987","DOI":"10.1093\/eurheartj\/ehx739","article-title":"Targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent atrial fibrillation: results of the RACE 3 trial","volume":"39","author":"Rienstra","year":"2018","journal-title":"Eur Heart J"},{"key":"2021110907011550700_euab213-B17","doi-asserted-by":"crossref","first-page":"3166","DOI":"10.1111\/jce.14774","article-title":"Healthcare utilization and cost in patients with atrial fibrillation and heart failure undergoing catheter ablation","volume":"31","author":"Field","year":"2020","journal-title":"J Cardiovasc Electrophysiol"}],"container-title":["EP Europace"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/23\/11\/1751\/41109593\/euab213.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/23\/11\/1751\/41109593\/euab213.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T07:02:08Z","timestamp":1636441328000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/23\/11\/1751\/6371911"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,17]]},"references-count":17,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,9,17]]},"published-print":{"date-parts":[[2021,11,8]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euab213","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,11,1]]},"published":{"date-parts":[[2021,9,17]]}}}