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Introduction: Although catheter ablation (CA) improves the outcome of the atrial fibrillation (AF) patients with low left ventricular ejection fraction (LVEF), it is still unknown whether the outcome of all AF patients with cardiomyopathy (CM) was improved by CA. Hypothesis: AF patients with some types of CM may get a good outcome by CA but AF patients with other types of CM may not. Methods: In multicenter, 60 AF patients with CM who underwent CA at the first time and whose LVEF was 50% or less were studied. All of them were well treated by medication before CA. They were classified by the type of CM into group 1 (dilated CM or tachycardia-induced CM, n=48) and group 2 (Fabry disease, ischemic CM or hypertrophic CM, n=12). Results: There was no difference between the two group in age (group 1; 62±11 years old vs. group 2; 65±15 years old, P=0.461) and LVEF (group 1; 38±9% vs. group 2; 38±10%, P=0.854). Forty patients in group 1 and 5 patients in group 2 were male (83% vs. 42%, P=0.003). Twelve patients in group 1 and 6 patients in group 2 had paroxysmal AF (25% vs. 50%, P=0.091). In group 1, their New York Heart Association (NYHA) classification (before; 1.7 ± 0.9 vs. after; 1.2 ± 0.4, P=0.001) and brain natriuretic peptide (BNP) level (before; 253 ± 397 pg/mL vs. after; 94 ± 140 pg/mL, P<0.001) were significantly improved after CA compared with before CA. In group 2, their NYHA classification (before; 1.8 ± 1.1 vs. after; 1.8 ± 0.9, P=1.000) and BNP level (before; 458 ± 292 pg/mL vs. after; 354 ± 345 pg/mL, P=0.182) were not significantly changed after CA compared with before CA. The improvement of LVEF between before and after CA was significantly higher in group 1 than group 2 (18±11% vs. 5±11%, P=0.001). The mean follow-up period was 1189±696 days. AF recurred more frequently in group2 than group1 (7/12 [58%] vs. 12/48 [25%], Log rank P=0.045). Conclusion: AF patients with dilated CM or tachycardia-induced CM got a good outcome by CA but AF patients with Fabry disease, ischemic CM or hypertrophic CM might not. [ABSTRACT FROM AUTHOR]