Abstract
BackgroundThe influence of hemodynamic parameters on the recurrence of atrial fibrillation (AF) after catheter ablation is not well known, and it remains unclear whether a nomogram combining risk factors and hemodynamic parameters improves prediction accuracy. ObjectiveThis study aimed to develop a nomogram on the basis of echocardiographic hemodynamic parameters for predicting AF recurrence after catheter ablation in nonvalvular atrial fibrillation (NVAF). MethodsA total of 380 consecutive patients with NVAF undergoing AF catheter ablation treatment were prospectively included. Patients were divided into training and validation cohorts in a 7:3 ratio. The follow-up time averaged 9 months with a median of 12 months, during which 132 patients (34.7%) experienced AF recurrence. ResultsLeast absolute shrinkage and selection operator regression and Cox regression analyses identified 4 significant predictors of AF recurrence: persistent AF (hazard ratio [HR] 1.63; 95% confidence interval [CI] 1.02–2.61; P = .041), S/D ratio of pulmonary vein (HR 0.50; 95% CI 0.30–0.84; P = .009), left atrial acceleration factor α (HR 1.31; 95% CI 1.02–1.68; P = .032), and left atrial appendage peak emptying flow velocity (HR 0.98; 95% CI 0.97–0.99; P = .004). On the basis of these 4 variables, a predictive nomogram was constructed. The nomogram demonstrated C indices of 0.664 and 0.728 for predicting 1- and 2-year AF recurrence, respectively, in the validation cohort. The Kaplan-Meier survival analysis indicated that a Nomo score of >128 was associated with a higher risk of AF recurrence. ConclusionHemodynamic parameters may offer valuable insight into predicting AF recurrence after catheter ablation. Our study successfully developed a reliable nomogram on the basis of echocardiographic hemodynamic parameters to estimate the risk of AF recurrence after catheter ablation in patients with NVAF.
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