{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:50:13Z","timestamp":1791453013727,"version":"4.3.3"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Patients with nonischemic cardiomyopathy (NICM) and ventricular tachycardia are at increased risk for adverse HF outcomes, and abnormal left ventricular (LV) substrate identified by endocardial unipolar and bipolar low-voltage areas (LVAs) may aid in risk stratification. This study assessed the association of LV unipolar and bipolar LVAs with end-stage HF outcomes in patients with NICM undergoing ventricular tachycardia ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      Patients with NICM and LV ejection fraction (EF) &lt;50% undergoing ventricular tachycardia ablation from 2019 to 2023 were included. Endocardial voltage mapping defined confluent (&gt;2 cm\n                      <jats:sup>2<\/jats:sup>\n                      ) unipolar LVAs as &lt;8.27 mV and bipolar LVAs as &lt;1.5 mV during sinus or paced rhythm. End-stage HF outcomes included HF death, LV assist device implantation, or heart transplant. Multivariable Cox proportional hazards regression analysis assessed associations between unipolar\/bipolar LVAs and end-stage HF outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      One hundred eleven patients with NICM (mean age, 64.6\u00b19.8 years; 81.1% male; mean LVEF, 33.8\u00b111.7%) were included. During a median follow-up of 28.1 months (interquartile range, 18\u201346), 28 (25.2%) patients experienced end-stage HF outcomes. Unipolar LVA (hazard ratio, 1.03 per 1% increase [95% CI, 1.01\u20131.05];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.002) and LVEF (hazard ratio, 1.04 per 1% decrease [95% CI, 1.00\u20131.09];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.03) were independently associated with higher end-stage HF risk, while bipolar LVA was not (hazard ratio, 0.98, 1% increase [95% CI, 0.96\u20131.01];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.25). A 3-point risk score based on the Youden index, unipolar LVA \u226570% (2 points), 35% to 70% (1 point), and LVEF \u226425% (1 point), had 82.1% sensitivity and 77.1% specificity for predicting end-stage HF in scores \u22652.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In patients with NICM undergoing ventricular tachycardia ablation, unipolar LVA and LVEF are independent predictors of end-stage HF outcomes. Integrating these predictors yields a prognostic score to identify patients at the highest risk of end-stage HF outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.126.014886","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:00:11Z","timestamp":1791450011000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Value of Left Ventricular Low Voltage Area and Ejection Fraction in Predicting End-Stage Heart Failure Outcomes After Ventricular Tachycardia Ablation in Patients With Non-Ischemic Cardiomyopathy"],"prefix":"10.1161","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9576-5978","authenticated-orcid":true,"given":"Arian","family":"Afzalian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2422-2930","authenticated-orcid":true,"given":"Alireza","family":"Oraii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7188-2686","authenticated-orcid":true,"given":"Corentin","family":"Chaumont","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2746-3243","authenticated-orcid":true,"given":"Oriol","family":"Rodriguez-Queralto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2588-3757","authenticated-orcid":true,"given":"Yuichiro","family":"Sagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5091-5725","authenticated-orcid":true,"given":"Carli 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