{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:20:03Z","timestamp":1789708803330,"version":"4.0.1"},"reference-count":11,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100015652","name":"Barts Charity","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015652","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2025,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Exercise Oscillatory Ventilation (EOV) and a steep ventilatory efficiency (VE\/VCO2) slope are features of ventilatory inefficiency on cardiopulmonary exercise testing (CPET), both associated with poor prognosis in patients with heart failure (HF). The prevalence in patients with co\u2010existent atrial fibrillation (AF) and the impact of catheter ablation (CA) is unknown.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To characterize ventilatory inefficiency in patients with persistent AF and Left Ventricular Systolic Dysfunction (LVSD) and assess the impact of CA.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Patients with persistent AF and Left Ventricular Ejection Fraction (LVEF) <\u200950% undergoing first\u2010time CA were prospectively enrolled. Echocardiography and CPET were performed at baseline and 6 months post\u2010CA. EOV was defined using the Kremser\u2013Corr\u00e0 criteria, and VE\/VCO2 slope gradient >\u200930 was considered abnormal.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 53 participants were enrolled (mean LVEF of 34\u2009\u00b1\u20099%). A total of 10 (19.2%) exhibited EOV at baseline. These patients had larger indexed left atrial (41.6\u2009\u00b1\u200913.1\u2009mL\/m\n 2<\/jats:sup>\n vs. 33.3\u2009\u00b1\u20099.3\u2009mL\/m\n 2<\/jats:sup>\n ,\n p<\/jats:italic>\n \u2009=\u20090.03) and ventricular volumes [65.7\u2009mL\/m\n 2<\/jats:sup>\n (57.1, 89.0) vs. 46.7\u2009mL\/m\n 2<\/jats:sup>\n (39.8, 61.4),\n p<\/jats:italic>\n \u2009=\u20090.03]. The partial pressure of end\u2010tidal carbon dioxide (P\n ET<\/jats:sub>\n CO\n 2<\/jats:sub>\n ) at peak exercise increased (33.7\u2009\u00b1\u20096.1\u2009mmHg to 41.2\u2009\u00b1\u20095.8\u2009mmHg,\n p<\/jats:italic>\n \u2009<\u20090.001) and correlated with improvement in HF symptoms (\n p<\/jats:italic>\n \u2009=\u2009\u22120.003) and objective HF markers. A total of 25 (48.1%) had an abnormal VE\/VCO2 gradient. The EOV pattern resolved in eight (80%) participants due to a reduction in EOV burden (71.1\u2009\u00b1\u200911.9% vs. 48.8\u2009\u00b1\u200914.8%,\n p<\/jats:italic>\n \u2009=\u20090.006) and the component amplitude of minute ventilation cycles (2.6\u2009L\/min (2.5,3.2) vs 2.2\u2009L\/min (1.8,2.6),\n p<\/jats:italic>\n \u2009=\u20090.028). Fewer patients had an abnormal VE\/VCO2 gradient after CA [25 (48.1%) vs. 16 (34.0%),\n p<\/jats:italic>\n \u2009=\u20090.004].\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Ventilatory inefficiency is common in patients with AF and LVSD. CA improves both EOV and VE\/VCO2 in AF\u2010induced cardiomyopathy. Improvement in P\n ET<\/jats:sub>\n CO\n 2<\/jats:sub>\n is also seen and correlates with HF symptom burden.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jce.16606","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T04:14:19Z","timestamp":1740111259000},"page":"945-951","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Catheter Ablation Improves Ventilatory Efficiency in Atrial Fibrillation\u2010Mediated Cardiomyopathy"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1257-5576","authenticated-orcid":false,"given":"Nikhil","family":"Ahluwalia","sequence":"first","affiliation":[{"name":"St Bartholomew's Hospital, Barts Heart Centre London UK"},{"name":"Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Bruce","sequence":"additional","affiliation":[{"name":"St Bartholomew's Hospital, Barts Heart Centre London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Ashdown","sequence":"additional","affiliation":[{"name":"St Bartholomew's Hospital, Barts Heart Centre London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Focacci","sequence":"additional","affiliation":[{"name":"St Bartholomew's Hospital, Barts Heart Centre London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakam","family":"Abbass","sequence":"additional","affiliation":[{"name":"St Bartholomew's Hospital, Barts Heart Centre London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shohreh","family":"Honarbakhsh","sequence":"additional","affiliation":[{"name":"St Bartholomew's Hospital, Barts Heart Centre London UK"},{"name":"Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Chow","sequence":"additional","affiliation":[{"name":"St Bartholomew's Hospital, Barts Heart Centre London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehul","family":"Dhinoja","sequence":"additional","affiliation":[{"name":"St Bartholomew's Hospital, Barts Heart Centre London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross J.","family":"Hunter","sequence":"additional","affiliation":[{"name":"St Bartholomew's Hospital, Barts Heart Centre London UK"},{"name":"Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Petersen","sequence":"additional","affiliation":[{"name":"St Bartholomew's Hospital, Barts Heart Centre London UK"},{"name":"Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Lloyd","sequence":"additional","affiliation":[{"name":"St Bartholomew's Hospital, Barts Heart Centre London UK"},{"name":"Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Schilling","sequence":"additional","affiliation":[{"name":"St Bartholomew's Hospital, Barts Heart Centre London UK"},{"name":"Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.02.033"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000072767.89944.6E"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2020.03.006"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.92.3.555"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.024141"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31826fb946"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJR.0b013e32832a4f54"},{"key":"e_1_2_10_9_1","first-page":"1158","article-title":"Cardiopulmonary Exercise Testing in Patients With Asymptomatic Left Ventricular Dysfunction: Lack of Prognostic Predictive Power of Ventilatory Variables","volume":"29","author":"Corr\u00e0 U.","year":"2022","journal-title":"European Journal of Preventive Cardiology"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-2146"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(87)91116-7"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2306037"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.16606","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.16606","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.16606","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:06:00Z","timestamp":1772964360000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.16606"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,21]]},"references-count":11,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/jce.16606"],"URL":"https:\/\/doi.org\/10.1111\/jce.16606","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,21]]},"assertion":[{"value":"2024-09-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}