{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T19:47:40Z","timestamp":1793908060315,"version":"4.8.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T00:00:00Z","timestamp":1675468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,30]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of our study was to assess differences in post-ablation atrial fibrillation (AF) recurrence and burden and to quantify the change in LVEF across different congestive heart failure (CHF) subcategories of the DECAAF-II population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Differences in the primary outcome of AF recurrence between CHF and non-CHF groups was calculated. The same analysis was performed for the three subgroups of CHF and the non-CHF group. Differences in AF burden after the 3-month blanking period between CHF and non-CHF groups was calculated. Improvement in LVEF was calculated and compared across the three CHF groups. Improvement was also calculated across different fibrosis stages. There was no significant differences in AF recurrence and AF burden after catheter ablation between CHF and non-CHF patients and between different CHF subcategories. Patients with heart failure with reduced ejection fraction (HFrEF) experienced the greatest improvement in EF following catheter ablation (CA, 16.66% \u00b1 11.98, P &amp;lt; 0.001) compared to heart failure with moderately reduced LVEF, and heart failure with preserved EF (10.74% \u00b1 8.34 and 2.00 \u00b1 8.34 respectively, P-value &amp;lt; 0.001). Moreover, improvement in LVEF was independent of the four stages of atrial fibrosis (7.71 vs. 9.53 vs. 5.72 vs. 15.88, from Stage I to Stage IV respectively, P = 0.115).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Atrial fibrillation burden and recurrence after CA is similar between non-CHF and CHF patients, independent of the type of CHF. Of all CHF groups, those with HFrEF had the largest improvement in LVEF after CA. Moreover, the improvement in ventricular function seems to be independent of atrial fibrosis in patients with persistent AF.<\/jats:p><\/jats:sec>","DOI":"10.1093\/europace\/euad018","type":"journal-article","created":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T12:11:14Z","timestamp":1675512674000},"page":"889-895","source":"Crossref","is-referenced-by-count":16,"title":["Catheter ablation improved ejection fraction in persistent AF patients: a DECAAF-II sub analysis"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8809-5419","authenticated-orcid":false,"given":"Mario","family":"Mekhael","sequence":"first","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2219-0709","authenticated-orcid":false,"given":"Botao","family":"Shan","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3179-4398","authenticated-orcid":false,"given":"Charbel","family":"Noujaim","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6624-1590","authenticated-orcid":false,"given":"Nour","family":"Chouman","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6443-798X","authenticated-orcid":false,"given":"Alaa","family":"Assaf","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7202-1164","authenticated-orcid":false,"given":"Hadi","family":"Younes","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4820-8102","authenticated-orcid":false,"given":"Abdel Hadi","family":"El Hajjar","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilas","family":"Dagher","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3163-8931","authenticated-orcid":false,"given":"Han","family":"Feng","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8989-0297","authenticated-orcid":false,"given":"Hua","family":"He","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6189-2821","authenticated-orcid":false,"given":"Omar","family":"Kreidieh","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9998-5601","authenticated-orcid":false,"given":"Chan Ho","family":"Lim","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8961-7976","authenticated-orcid":false,"given":"Chao","family":"Huang","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2128-1051","authenticated-orcid":false,"given":"Tarek","family":"Ayoub","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3271-7247","authenticated-orcid":false,"given":"Eugene","family":"Kholmovski","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Johns Hopkins University , 733 N Broadway, Baltimore, MD 21205 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9688-1604","authenticated-orcid":false,"given":"Mihail","family":"Chelu","sequence":"additional","affiliation":[{"name":"Baylor St. Luke's Medical Center , 1101 Bates Ave, Houston, TX 77030 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0454-0541","authenticated-orcid":false,"given":"Nassir","family":"Marrouche","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2878-9061","authenticated-orcid":false,"given":"Eoin","family":"Donnellan","sequence":"additional","affiliation":[{"name":"Tulane Research and Innovation for Arrhythmia Discoveries- TRIAD Center, Tulane University School of Medicine , 1430 Tulane Avenue, New Orleans, LA 70112 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,2,4]]},"reference":[{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1161\/CIRCULATIONAHA.115.018614","article-title":"Atrial fibrillation begets heart failure and vice versa: temporal associations and differences in preserved versus reduced ejection fraction","volume":"133","author":"Santhanakrishnan","year":"2016","journal-title":"Circulation"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1161\/01.CIR.89.2.724","article-title":"Echocardiographic predictors of nonrheumatic atrial fibrillation. The framingham heart study","volume":"89","author":"Vaziri","year":"1994","journal-title":"Circulation"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"E50","DOI":"10.1093\/eurheartj\/suaa059","article-title":"Atrial fibrillation ablation in heart failure","volume":"22","author":"Balla","year":"2020","journal-title":"Eur Heart J Suppl"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1093\/europace\/euac186","article-title":"Atrial fibrillation onset before heart failure or vice versa: what is worst? A nationwide register study","volume":"25","author":"Pallisgaard","year":"2023","journal-title":"Europace"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"e007731","DOI":"10.1161\/CIRCEP.119.007731","article-title":"Catheter ablation versus best medical therapy in patients with persistent atrial fibrillation and congestive heart failure: the randomized AMICA trial","volume":"12","author":"Kuck","year":"2019","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1093\/europace\/euac173","article-title":"Catheter ablation improves cardiovascular outcomes in patients with atrial fibrillation and heart failure: a meta-analysis of randomized controlled trials","volume":"25","author":"Simader","year":"2023","journal-title":"Europace"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1093\/europace\/euac108","article-title":"Catheter ablation for patients with atrial fibrillation and heart failure with reduced and preserved ejection fraction: insights from the KiCS-AF multicentre cohort study","volume":"25","author":"Shiraishi","year":"2023","journal-title":"Europace"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.hrthm.2017.12.001","article-title":"Catheter ablation of atrial fibrillation in patients with heart failure and preserved ejection fraction","volume":"15","author":"Black-Maier","year":"2018","journal-title":"Heart Rhythm"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1111\/jce.14957","article-title":"Efficacy of LGE-MRI-guided fibrosis ablation versus conventional catheter ablation of atrial fibrillation: the DECAAF II trial: study design","volume":"32","author":"Marrouche","year":"2021","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12968-018-0449-8","article-title":"Optimization of late gadolinium enhancement cardiovascular magnetic resonance imaging of post-ablation atrial scar: a cross-over study","volume":"20","author":"Chubb","year":"2018","journal-title":"J Cardiovasc Magn Reson"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1161\/CIRCEP.110.960690","article-title":"Success of ablation for atrial fibrillation in isolated left ventricular diastolic dysfunction: a comparison to systolic dysfunction and normal ventricular function","volume":"4","author":"Cha","year":"2011","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.amjcard.2020.09.018","article-title":"Comparison of outcomes after ablation of atrial fibrillation in patients with heart failure with preserved versus reduced ejection fraction","volume":"136","author":"Aldaas","year":"2020","journal-title":"Am J Cardiol"},{"key":"2023033021231592500_","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":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.jacep.2020.11.021","article-title":"Atrial fibrillation burden and clinical outcomes in heart failure: the CASTLE-AF trial","volume":"7","author":"Brachmann","year":"2021","journal-title":"JACC Clin Electrophysiol"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/j.hlc.2015.02.025","article-title":"Pulmonary vein isolation compared to rate control in patients with atrial fibrillation: a systematic review and meta-analysis","volume":"24","author":"Vaidya","year":"2015","journal-title":"Heart Lung Circulation"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"41","DOI":"10.7326\/M18-0992","article-title":"Catheter ablation of atrial fibrillation in patients with heart failure: A meta-analysis of randomized controlled trials","volume":"170","author":"Turagam","year":"2019","journal-title":"Ann Intern Med"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1136\/hrt.2010.207340","article-title":"Radiofrequency ablation for persistent atrial fibrillation in patients with advanced heart failure and severe left ventricular systolic dysfunction: a randomised controlled trial","volume":"97","author":"MacDonald","year":"2011","journal-title":"Heart"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1093\/europace\/euaa179","article-title":"Left atrial fibrosis predicts left ventricular ejection fraction response after atrial fibrillation ablation in heart failure patients: the fibrosis-HF study","volume":"22","author":"Kirstein","year":"2020","journal-title":"Europace"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/jce.12090","article-title":"Higher degree of left atrial structural remodeling in patients with atrial fibrillation and left ventricular systolic dysfunction","volume":"24","author":"Akkaya","year":"2013","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2023033021231592500_","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/S0735-1097(22)01095-6","article-title":"Persistent atrial fibrillation patients have higher atrial fibrosis and arrhythmia recurrence","volume":"79","author":"Mekhael","year":"2022","journal-title":"J Am Coll Cardiol"}],"container-title":["EP Europace"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/25\/3\/889\/49704115\/euad018.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/25\/3\/889\/49704115\/euad018.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T21:09:14Z","timestamp":1701724154000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/25\/3\/889\/7026077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,4]]},"references-count":20,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2,4]]},"published-print":{"date-parts":[[2023,3,30]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euad018","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,3,1]]},"published":{"date-parts":[[2023,2,4]]}}}