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The long⁃term prognosis of nonparoxysmal atrial fibrillation （NPAF） patients after radiofrequency catheter ablation
Received date: 2024-12-27
Online published: 2025-04-23
Objective To assess the long?term prognosis of nonparoxysmal atrial fibrillation （NPAF） patients after radiofrequency catheter ablation （RFCA） and identify influencing factors. Methods A prospective， randomized controlled trial was conducted from October 2021 to June 2023 at our center. A total of 183 consecutive NPAF patients undergoing RFCA were randomly assigned to the ARNI group （n = 91） or control group （n = 92）. Data collected included baseline characteristics， procedure?related parameters， low voltage areas （LVAs）， left atrial mean pressure （LMP）， and clinical outcomes at 12 months. The primary endpoint included freedom from atrial fibrillation recurrence at 12 months post?ablation and secondary endpoints comprised complication rates， mean arterial pressure （MAP）， left atrial diameter （LAD）， and cardiac function. Results The two groups presented no significant differences in baseline characteristics （P > 0.05）. The ARNI group demonstrateda significantly higher rate of freedom from AF recurrence compared to the control group at 12 months （79.12% vs. 66.30%， HR = 0.56， P = 0.039）. Moreover， the ARNI group showed significantly smaller LAD［（40.17 ± 4.72） mm vs. （42.29 ± 6.08） mm， P = 0.013） and a significantly lower N?terminal proB?type natriuretic peptide（NT?proBNP） level ［98.00 （45.00， 456.00） vs. 128.50 （73.50， 586.50）， P = 0.039］. Both groups showed no significant differences in complication rates or MAP post?ablation （P > 0.05）. Cox regression analysis identified ARNI as an independent predictor for maintaining freedom from AF recurrence at 12 months post?ablation（HR = 0.524， P = 0.038）. Subgroup analyses showed that high LMP patients had a lower rate of freedom from AF recurrence than those with normal pressures （51.61% vs. 83.47％， P < 0.001）， and demonstrated significantly improved ARNIoutcomes （64.52% vs. 38.71%， P = 0.042）. Conclusion ARNI improves long?term outcomes for NPAF patients following RFCA， particularly in those with highLMP.
Weixiang FENG , Juan WANG , Yanbin SONG , Sheliang XUE , Wenhua LI . The long⁃term prognosis of nonparoxysmal atrial fibrillation （NPAF） patients after radiofrequency catheter ablation[J]. The Journal of Practical Medicine, 2025 , 41(7) : 1036 -1043 . DOI: 10.3969/j.issn.1006-5725.2025.07.016
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