Arrhythmias & electrophysiologySecondary analysis
Characterization of Arrhythmia-Induced Cardiomyopathy Using Magnetic Resonance Imaging in Patients with Persistent Atrial Fibrillation and Left Ventricular Systolic Dysfunction – Insights from DECAAF II
- Secondary analysis of the DECAAF II randomised trial
- post-hoc analysis
Authors' conclusion
In this post-hoc analysis of the DECAAF II trial, we found that the majority of patients with LVSD and persistent AF have AIC rather than primary cardiomyopathy. We identified LGE-CMR as a differentiator between AIC and other cardiomyopathies.
Study context
- Population
- Patients with persistent atrial fibrillation (AF) and LV systolic dysfunction undergoing AF ablation with LGE-CMR before and 3 months afterof 815 in DECAAF II
- Participants
- 119 patients
- Comparison
- Arrhythmia-induced cardiomyopathy (AIC) vs non-AIC
- AICn = 72
- non-AICn = 47reference
- Primary endpoint
- Prevalence and pre-ablation predictors of AIC
Primary result
As reported in the abstract
AIC prevalence and pre-ablation predictors
| Group | Value | Baseline left ventricular ejection fraction (LVEF) | LA septal wall fibrosis |
|---|---|---|---|
| AIC | 60.5% | 39.1 ± 7.9% | 12.2 ± 10.0% |
| non-AIC | 39.5% | 39.2 ± 7.9% | 20.7 ± 11.4% |
- Baseline LVEF, AIC vs non-AIC
- P = 0.9
- LA septal wall fibrosis, AIC vs non-AIC
- P < 0.001
Further findings
LVEF improvement vs post-ablation AF burden
- LVEF improvement correlated with lower AF burden post-ablation (r = −0.23)
- P = 0.02
- Mean LVEF recovery (percentage points)
- 13.9
- Mean AF burden post-ablation
- 16.8 ± 20.2%
Original publication
Characterization of Arrhythmia-Induced Cardiomyopathy Using Magnetic Resonance Imaging in Patients with Persistent Atrial Fibrillation and Left Ventricular Systolic Dysfunction – Insights from DECAAF II. Eur J Heart Fail. Published 12 May 2025. doi:10.1002/ejhf.3684
Summarised from the published abstract; every number is checked against it