Risk factors and risk prediction for the recurrence of persistent atrial fibrillation after radiofrequency catheter ablation

Objective To investigate the risk factors and possible risk prediction methods concerning the recurrence of persistent atrial fibrillation (AF) after radiofrequency catheter ablation. Methods It was a single-center prospective observational study, where 53 patients with persistent AF, who underwent radiofrequency catheter ablation for the first time from July 2018 to August 2019 in Department of Cardiology, the Affiliated Hospital of Xuzhou Medical University, were consecutively enrolled. Their clinical data were recorded, while left atrial voltage mapping was performed after circle pulmonary vein isolation under sinus rhythm. The average follow-up visit time was 16(12, 21) months to determine the presence of recurrence. COX multivariate analysis was conducted to explore the risk factors and predict the risk of recurrence. Results In the current study, 14 patients (26.42%) showed atrial fibrillation recurrence. The recurrence group showed remarkably extended mean P wave duration (mPWD) (P<0.01) and reduced mean left atrial voltage (mLAV) (P<0.01), compared with the successful group. COX multivariate regression analysis showed that both mPWD and mLAV were the independent risk factors of atrial fibrillation recurrence (P<0.05). Both mPWD and mLAV indexes were adopted to establish a predictive model. A ROC curve was plotted to predict the risk of atrial fibrillation recurrence, with AUC=0.90 (95%CI 0.80~0.99, P<0.01). The cut-off value of the predicted P value was 0.41, with a sensitivity and specificity of 0.786 and 0.949, respectively. Conclusions The duration of P wave and the left atrial voltage can effectively predict the recurrence risk of persistent atrial fibrillation after single radiofrequency catheter ablation.