Evidence map›Paper›PMID 42178525›Full record

ArticleBMC cardiovascular disorders2026

Association of cardiovascular-kidney-metabolic burden with recurrence after first ablation in patients with persistent atrial fibrillation.

Peiyang Zheng, Zhuoran Jia, Huimin Wang, Xiaohe Wu, Ao Liang, Danni Li, Yinguang Fan, Xiaohu Li, Ren Zhao

Abstract read
In one paragraph

Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Peiyang ZhengDepartment of Cardiology, National Cardiovascular Disease Regional Center for Anhui, The First Affiliated Hospital of Anhui Medical University, No. 120, Wanshui Road, Shushan District, Hefei, Anhui, 230088, China.
Zhuoran JiaDepartment of Cardiology, National Cardiovascular Disease Regional Center for Anhui, The First Affiliated Hospital of Anhui Medical University, No. 120, Wanshui Road, Shushan District, Hefei, Anhui, 230088, China.
Huimin WangDepartment of Cardiology, National Cardiovascular Disease Regional Center for Anhui, The First Affiliated Hospital of Anhui Medical University, No. 120, Wanshui Road, Shushan District, Hefei, Anhui, 230088, China.
Xiaohe WuDepartment of Cardiology, National Cardiovascular Disease Regional Center for Anhui, The First Affiliated Hospital of Anhui Medical University, No. 120, Wanshui Road, Shushan District, Hefei, Anhui, 230088, China.
Ao LiangDepartment of Cardiology, National Cardiovascular Disease Regional Center for Anhui, The First Affiliated Hospital of Anhui Medical University, No. 120, Wanshui Road, Shushan District, Hefei, Anhui, 230088, China.
Danni LiDepartment of Cardiology, National Cardiovascular Disease Regional Center for Anhui, The First Affiliated Hospital of Anhui Medical University, No. 120, Wanshui Road, Shushan District, Hefei, Anhui, 230088, China.
Yinguang FanSchool of Public Health, Anhui Medical University, No. 2227, Hangbuhe Road, Feixi County, Hefei, Anhui, 231200, China.
Xiaohu LiDepartment of Radiology, Research Center of Clinical Medical Imaging, The First Affiliated Hospital of Anhui Medical University, Anhui Province Clinical Image Quality Control Center, No. 218 Jixi Road, Hefei, Anhui, 230022, China.
Ren ZhaoDepartment of Cardiology, National Cardiovascular Disease Regional Center for Anhui, The First Affiliated Hospital of Anhui Medical University, No. 120, Wanshui Road, Shushan District, Hefei, Anhui, 230088, China. zhaoren@ahmu.edu.cn.

Funding

the National Natural Science Foundation of China 82371949
6 · The paper itself

Abstract

backgroundRecurrence after first radiofrequency catheter ablation remains common in patients with non-valvular persistent atrial fibrillation. Cardiovascular-kidney-metabolic burden may contribute to atrial remodeling and adverse ablation outcomes, but its relationship with post-ablation recurrence and downstream atrial substrate markers remains incompletely understood.

methodsWe retrospectively enrolled 730 patients with non-valvular persistent atrial fibrillation who underwent first-time radiofrequency catheter ablation. Cardiac, kidney, and metabolic domains were integrated into a weighted cardiovascular-kidney-metabolic burden score, and patients were stratified by tertiles. Sequential Cox regression models were constructed to evaluate the association between burden and recurrence after adjustment for clinical characteristics and downstream atrial substrate markers, including left atrial diameter, log(BNP), and fine f-wave. Model discrimination was assessed using Harrell's C-index and time-dependent receiver operating characteristic analysis.

resultsDuring follow-up, 228 patients (31.2%) developed recurrence. Compared with the low-burden tertile, intermediate- and high-burden tertiles were associated with a significantly higher risk of recurrence in the primary adjusted model (intermediate vs. low: HR = 1.49, 95% CI 1.05-2.11; high vs. low: HR = 1.60, 95% CI 1.13-2.27). Further adjustment for left atrial diameter, log(BNP), and fine f-wave attenuated these associations, suggesting partial statistical overlap between upstream multisystem burden and downstream atrial substrate abnormalities. In continuous analyses, each 1-standard deviation increase in weighted burden remained associated with recurrence risk. Addition of substrate markers improved model discrimination.

conclusionHigher cardiovascular-kidney-metabolic burden was associated with recurrence after first ablation in patients with non-valvular persistent atrial fibrillation, suggesting partial statistical overlap between upstream multisystem burden and downstream atrial substrate abnormalities.

Indexed as

Atrial FibrillationCatheter AblationKidneyAgedAtrial RemodelingBiomarkersFemaleHumansMaleMiddle AgedRecurrenceRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeBiomarkersatrial fibrillationcardiovascular-kidney-metabolicradiofrequency catheter ablationrecurrencerisk stratification

Identifiers

PMID42178525
PMCPMC13383483

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.