Abstract
Atrial fibrillation (AF) is associated with high rates of recurrence after radiofrequency ablation (RFA). This retrospective observational study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology statement to evaluate whether combined serological and echocardiographic indicators predict postablation recurrence. We retrospectively reviewed 97 nonvalvular AF patients who underwent 1st-time RFA at our institution between April 2021 and April 2023. Patients were classified into recurrence (n = 21) and nonrecurrence (n = 76) groups based on documented AF recurrence within 12 months. Data collection followed prespecified variable definitions: demographic and clinical characteristics, serological markers (N-terminal pro-B-type natriuretic peptide [NT-proBNP] and cardiac troponin I [cTnI]), and standardized echocardiographic parameters (left atrial diameter [LAD], left ventricular end-diastolic diameter [LVDD], and left ventricular ejection fraction [LVEF]). We controlled for selection bias by applying strict inclusion/exclusion criteria and blinded measurement of all variables. Logistic regression identified independent predictors of recurrence, and receiver operating characteristic curve analysis quantified predictive performance. After adjustment for confounders, elevated NT-proBNP, cTnI, LAD, and LVDD were independent risk factors (OR range 2.401-3.251; P < .05), while higher LVEF was protective (OR = 0.279; P < .05). The combined model achieved an area under the curve of 0.771 (95% CI: 0.660-0.883; sensitivity 74.1%, specificity 75.7%). In this retrospective study, the combined measurement of NT-proBNP, cTnI, LAD, LVDD, and LVEF demonstrated robust discriminatory power for predicting AF recurrence after RFA.