Arrhythmias & electrophysiology

Left ventricular ejection fraction response after atrial fibrillation ablation: Clinical predictors and development of the PACED score

Heart RhythmPublished Multicentre cohort study

Authors' conclusion

LVEF response post-AF ablation in patients with LVSD can be accurately predicted precatheter ablation with a bedside score. Left ventricular response depends primarily on substrate and conduction characteristics rather than pharmacotherapy in a guideline-directed medical therapy-optimized cohort. Late gadolinium enhancement on cardiac magnetic resonance is associated with an increased chance of being a nonresponder to ablation.

Study context

Population
Patients with atrial fibrillation (AF) and left ventricular ejection fraction (LVEF) <50% undergoing index ablation
Participants
366 patients
Outcome
Responder status: ≥10% increase in LVEF or improvement to ≥50% on follow-up echocardiography
Follow-up
After the final ablation

Main finding

As reported in the abstract

LV responders · follow-up

LV responders

70.8%

PACED score <2: probability of response

87%

PACED score ≥3: probability of nonresponse

71%

PACED score c-statistic

0.83

95% CI 0.77–0.89

Observational data: associations, not effects.

Further findings

Late gadolinium enhancement on CMR, nonresponders vs responders (CMR subcohort)

P < 0.001

Guideline-directed medical therapy at baseline

Not independently associated with recovery

Original publication

Left ventricular ejection fraction response after atrial fibrillation ablation: Clinical predictors and development of the PACED score. Heart Rhythm. Published 26 November 2025. doi:10.1016/j.hrthm.2025.11.039

Composed by AI from the published abstract and checked against it. How Briefs are made →

Get them every week

New studies on this topic in My Week and in your Monday e-mail.

We e-mail you a sign-in link and a code. No password, no spam.