![]() 3, 5, 6, 7 However, in patients with AF and a reduced LVEF, there have been no absolute parameters that can distinguish arrhythmia‐induced cardiomyopathy from dilated cardiomyopathy before the procedure. 2 Catheter ablation of atrial fibrillation (AF) is gaining a significant role in heart failure treatment of patients with concomitant AF and atrial flutter (AFL), as confirmed by the guidelines, 3, 4 and the superiority over antiarrhythmic drug therapy with respect to the mortality, hospitalizations, exercise capacity, and quality of life, has been reported in randomized control trials and meta‐analyses. 1 The LV ejection fraction (LVEF) is a well‐known powerful factor for predicting the clinical outcome in patients with a reduced LVEF, and an improved or recovered LVEF by medical therapy contributes to a lower mortality and less frequent hospitalizations. It has been widely accepted that left ventricular (LV) systolic dysfunction is reversible in a part of the patients once the arrhythmia is controlled, which is called arrhythmia‐induced cardiomyopathy. In the multivariate analysis, the preprocedural high‐sensitivity troponin T was the only independent predictor of the recovery of the LV dysfunction during the late phase after ablation (odds ratio, 1.17 95% CI, 1.06–1.33 P=0.001), and a level of ≤12 pg/mL predicted recovery of the LV dysfunction with a high accuracy (sensitivity, 90.0% specificity, 76.7% positive predictive value, 56.3% and negative predictive value, 95.8%). The preprocedural echocardiographic parameters were comparable between the responders and nonresponders. Responders were defined as having a normalized LVEF (≥50%) during the late phase after the ablation. Forty patients with a reduced LVEF (LVEF 3 months) after the ablation. ![]()
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