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. 2016 Oct 10;134(15):1068–1081. doi: 10.1161/CIRCULATIONAHA.116.022931

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© 2016 The Authors.

Circulation is published on behalf of the American Heart Association, Inc., by Wolters Kluwer. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.

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Figure 6. — Proposed schematic representation of the relationships between lone atrial fibrillation (AF), subtle left ventricular (LV) dysfunction, and upstream cardiomyopathy and the effect of ablation. A, Lone AF and subtle LV dysfunction may be tissue-specific manifestations of an upstream occult cardiomyopathy, characterized by impaired energetics. AF further contributes to LV dysfunction via adverse hemodynamics. B, Successful catheter ablation restores sinus rhythm and/or reduces AF burden and leads to a modest increase in LV function via improvement in hemodynamics. However, the underlying cardiomyopathy remains, and myocardial energetics and LV function do not normalize.