INCLUSION:
AIC (Cases):
* Age ≥18
* Persistent AF before index catheter ablation or cardioversion
* LVEF ≤40% during rate-controlled (resting HR \<100bpm, mean HR on 24-hour Holter \<100bpm) AF prior to index catheter ablation or cardioversion
* LVEF normalisation (LVEF ≥55%) in SR, post-catheter ablation or cardioversion (≥3 months post-catheter ablation or cardioversion), no AF (\>30 seconds of continuous AF) detected outside blanking period (8 weeks post-catheter ablation), and with no new introduction of any new or increased dose of heart failure guideline-directed medical therapy (GDMT) (renin-angiotensin-aldosterone system inhibitors (RAASi), Sodium Glucose Co-transporter 2 (SLGT2) inhibitors, increased dose of beta-blocker (BB), mineralocorticoid receptor antagonist (MRA))
AF-pEF (Negative controls):
* Age ≥18
* Persistent AF before index catheter ablation or cardioversion
* LVEF ≥55% during rate-controlled (resting HR \<100bpm) AF. AIC-genotyping study, v1.7, 27.01.26 Page 13 of 28
AF/HF non-responders (Positive controls)
* Age ≥18
* Persistent AF before index catheter ablation or cardioversion
* LVEF ≤40% during rate-controlled (resting HR \<100bpm) AF before index catheter ablation or cardioversion.
* Persistent LVSD (LVEF ≤40%) in SR, post-catheter ablation or cardioversion (≥3 months post-catheter ablation or cardioversion), no AF (\>30 seconds of continuous AF) detected outside blanking period (8 weeks post-catheter ablation) and with no change in heart failure GDMT (RAASi, SGLT2 inhibitors, increased dose of BB, MRA).
EXCLUSION:
AIC (Cases).
* No alternative cause for LVSD (ischemic cardiomyopathy/non-ischaemic cardiomyopathy before AF diagnosis, primary valve disease, inherited cardiomyopathy
* Any pregnancy during AF or in the 12 months preceding LVSD onset.
* Alcohol intake \>21 units/week
* Any history of cardiotoxic chemotherapy
AF-pEF (Negative controls)
* No known cause for LVSD (ischemic cardiomyopathy/non-ischaemic cardiomyopathy before AF diagnosis, primary valve disease, inherited cardiomyopathy).
* Any pregnancy during AF or in the 12 months preceding LVSD onset.
* Alcohol intake \>21 units/week.
* Any history of cardiotoxic chemotherapy.
AF/HF non-responders (Positive controls)
* No alternative cause for LVSD (ischemic cardiomyopathy/non-ischaemic cardiomyopathy before AF diagnosis, primary valve disease, inherited cardiomyopathy).
* Any pregnancy during AF or in the 12 months preceding LVSD onset.
* Alcohol intake \>21 units/week.
* Any history of cardiotoxic chemotherapy.
