Evidence map›Paper›PMID 40056366›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2025

Impact of catheter ablation on atrial fibrillation outcomes in various cardiomyopathies: findings from LGE-MRI quantified atrial fibrosis analysis.

Ahmad Kassar, Nadia Chamoun, Romanos Haykal, Yaacoub Chahine, Hala Al Yasiri, Tori Hensley, David Owens, Nazem Akoum

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Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Atrial electrophysiology in hypertrophic cardiomyopathy: current insights and knowledge gaps.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ahmad KassarDivision of Cardiology, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA.
Nadia ChamounDivision of Cardiology, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA.
Romanos HaykalDivision of Cardiology, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA.
Yaacoub ChahineDepartment of Medicine, University of Washington, Seattle, WA, USA.
Hala Al YasiriDivision of Cardiology, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA.
Tori HensleyDivision of Cardiology, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA.
David OwensDivision of Cardiology, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA.
Nazem AkoumDivision of Cardiology, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA. nakoum@cardiology.washington.edu.ORCID http://orcid.org/0000-0002-2001-6806

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiomyopathy (CM) is associated with atrial remodeling and atrial fibrillation (AF), often complicating rhythm management. Ventricular dysfunction contributes to AF through pressure and volume overload, while AF worsens ventricular function via tachycardia and irregular activation. Evidence suggests catheter ablation improves outcomes in CM patients, though success is influenced by the extent of atrial and ventricular remodeling.

methodsPatients undergoing their first catheter ablation for AF were divided into hypertrophic (HCM), ischemic (ICM), non-ischemic (NICM), and no-CM groups. Pre-ablation late-gadolinium enhancement cardiac magnetic imaging (LGE-MRI) was used to assess left atrial (LA) fibrosis burden and anatomical distribution. Patients were followed prospectively for arrhythmia recurrence.

resultsA total of 552 patients, 39 HCM (69% obstructive), 39 ICM, 115 with NICM, and 359 without CM were included between January 2015 and December 2022. LA fibrosis was significantly higher in patients with CM (19.1 ± 7.5% vs. 16.5 ± 6.9%; P = 0.01). HCM and ICM had the greatest LA fibrosis among the different CM subtypes (21.3 ± 8.7% and 21.9 ± 9.1%, respectively). There was no significant difference in the regional distribution of fibrosis among the various groups. AF recurrence was observed in 321 (58.2%) after 456 (175-1204) days. Multivariate analysis revealed that compared to no CM, HCM was associated with a three-fold increase in AF recurrence (HR = 3.07, 95% CI 2.06-4.58, P < 0.001), followed by ICM (HR 1.61, 95%, CI 0.95-2.72; P = 0.07) and NICM (HR of 1.53, 95% CI 1.14-2.06; P = 0.05). LA fibrosis and volume index were independently associated with recurrence (HR = 1.03, 95% CI 1.01-1.06, P = 0.01 and HR = 1.02, 95% CI 1.01-1.03, P = 0.01). Genetic testing revealed key distinctions between HCM and NICM, with MYBPC3 and MYH7 as prominent genes in HCM and a heterogeneous genetic basis in NICM.

conclusionHypertrophic cardiomyopathy is associated with the highest risk of AF recurrence followed by ischemic and non-ischemic cardiomyopathy after catheter ablation. LA fibrosis regional patterns did not differ between cardiomyopathy types, while overall fibrosis and volume predicted recurrence.

Indexed as

Atrial FibrillationCardiomyopathiesCatheter AblationHeart AtriaAgedAtrial RemodelingContrast MediaFemaleFibrosisHumansMagnetic Resonance ImagingMagnetic Resonance Imaging, CineMaleMiddle AgedRecurrenceTreatment OutcomeContrast MediaAtrial fibrillationAtrial fibrosisCardiomyopathyCatheter ablation

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.