{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:31:03Z","timestamp":1789576263175,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,11,9]],"date-time":"2012-11-09T00:00:00Z","timestamp":1352419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:p><jats:bold>AF Ablation and Impaired Left Ventricular Function.<\/jats:bold>\u2003<jats:italic>Introduction:<\/jats:italic> Long\u2010term outcome of AF ablation in patients with impaired LVEF is unknown. The aim of this study is to evaluate sinus rhythm (SR) maintenance, clinical status, and echocardiographic parameters over a long\u2010term period following atrial fibrillation (AF) transcatheter ablation in patients with left ventricular ejection fraction (LVEF) &lt;50%.<\/jats:p><jats:p><jats:italic>Methods and Results:<\/jats:italic> A total of 196 patients (87.2% males, age 60.5 \u00b1 10.2 years) with LVEF &lt;50% underwent radiofrequency transcatheter ablation for paroxysmal (22.4%) or persistent (77.6%) AF. Patients were followed up for 46.2 (16.4\u201363.5) months regarding AF recurrences, functional class, and echocardiographic parameters. All patients underwent pulmonary vein isolation, while 167 (85.2%) required additional atrial lesions. Eleven (5.6%) patients suffered procedural complications. During follow\u2010up, 58 (29.6%) patients required repeated ablations. At the follow\u2010up end, 15 (7.7%) patients died, while 74 (37.8%) documented at least one episode of AF, atrial flutter, or atrial ectopic tachycardia. Eighty\u2010three (47.2%) patients maintained antiarrhythmic drugs. During follow\u2010up, NYHA class improved by at least one class more frequently among patients maintaining SR compared to those experiencing relapses (70.6% vs 47.9%, P = 0.003). LVEF showed a broader relative increase in patients maintaining SR (32.7% vs 21.4%; P = 0.047) and mitral regurgitation grading significantly decreased (P &lt;0.001) only within these patients. At multivariable analysis SR maintenance emerged as an independent predictor (odds ratio 4.26, 95% CI 1.69\u201310.74, P = 0.002) of long\u2010term clinical improvement (reduction in NYHA class \u22651 and relative increase in LVEF \u226510%).<\/jats:p><jats:p><jats:italic>Conclusions:<\/jats:italic> Although not substantially worse than in patients with preserved LVEF, AF ablation in patients with impaired LVEF is affected by high long\u2010term recurrence rate. Among these patients SR maintenance is associated with greater clinical improvement. <jats:italic>(J Cardiovasc Electrophysiol, Vol. 24, pp. 24\u201032, January 2013)<\/jats:italic><\/jats:p>","DOI":"10.1111\/j.1540-8167.2012.02419.x","type":"journal-article","created":{"date-parts":[[2012,7,25]],"date-time":"2012-07-25T17:32:53Z","timestamp":1343237573000},"page":"24-32","source":"Crossref","is-referenced-by-count":39,"title":["Long\u2010Term Results of Transcatheter Atrial Fibrillation Ablation in Patients with Impaired Left Ventricular Systolic Function"],"prefix":"10.1111","volume":"24","author":[{"given":"MATTEO","family":"ANSELMINO","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"STEFANO","family":"GROSSI","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MARCO","family":"SCAGLIONE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DAVIDE","family":"CASTAGNO","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"FRANCESCA","family":"BIANCHI","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GAETANO","family":"SENATORE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MARIO","family":"MATTA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DARIO","family":"CASOLATI","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"FEDERICO","family":"FERRARIS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YVONNE","family":"CRISTOFORETTI","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ALESSANDRO","family":"NEGRO","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"FIORENZO","family":"GAITA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,11,9]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq278"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e318214876d"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2007.00956.x"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000095796.45180.88"},{"key":"e_1_2_5_6_2","doi-asserted-by":"crossref","first-page":"2539","DOI":"10.1161\/hc4601.098517","article-title":"Atrial electroanatomical remodeling after circumferential radiofrequency pulmonary vein ablation: Efficacy of an anatomic approach in a large cohort of patients with atrial fibrillation","volume":"104","author":"Pappone C","year":"2001","journal-title":"Circulation"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.108.774885"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eur062"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.109.859116"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.09.056"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041018"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2006.00471.x"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2006.00653.x"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0708234"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eun076"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.10.044"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.06.053"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eup309"},{"key":"e_1_2_5_19_2","doi-asserted-by":"crossref","first-page":"2118","DOI":"10.1161\/circ.104.17.2118","article-title":"American College of Cardiology\/American Heart Association Task Force on Practice Guidelines; European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients with Atrial Fibrillation); North American Society of Pacing and Electrophysiology: ACC\/AHA\/ESC Guidelines for the Management of Patients With Atrial Fibrillation: Executive summary. 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