Abstract Body (Do not enter title and authors here): Background Non-alcoholic fatty liver disease (NAFLD) is not only a predictor of new onset of atrial fibrillation (AF), but also a predictor of AF recurrence following catheter ablation. Advanced liver fibrosis increase susceptibility to AF in NAFLD population. However, the effect of liver fibrosis levels on AF recurrence after catheter ablation remains unclear in the general population. This study was conducted to explore the effect of liver fibrosis on AF recurrence after radiofrequency catheter ablation (RFCA).
Methods The study was a prospective observational cohort study that enrolled consecutive inpatients who underwent their first RFCA of AF from June 2021 to August 2022 at the China Japan Friendship hospital and the First Affiliated Hospital of Zhengzhou University. Liver stiffness measurement (LSM) was performed by VCTE in all enrolled patients before ablation. The study endpoint was recurrence after ablation. The predictive values of SHR for adverse events were assessed.
Results The study finally included 279 patients with AF. Multivariate Cox regression analysis showed that a high level of LSM value was an independent predictor of AF recurrence following ablation, both as a continuous and a categorical variable. Kaplan-Meier curve analysis revealed that a significant disparity inthe recurrence of AF following ablation among the three groups with different levels of LSM value (P value<0.001). Furthermore, restricted cubic spline showed an increasing risk of AF recurrence with increasing LSM values, based on an LSM value of 9.6 kPa as the reference point. Subgroup analyses revealed that a significant interaction between the presence or absence of NAFLD and the levels of LSM value on AF recurrence after ablation (P value for interaction=0.046). Kaplan-Meier curves showed that the rate of AF recurrence was significantly higher with LSM value≥6.9 kPa in NAFLD patients. Multivariate Cox regression analysis also demonstrated that NAFLD patients with LSM≥6.9 kPawere independent factors of higher risk of AF recurrence after RFCA.
Conclusions A high level of LSM value was a predictor for the risk of AF recurrence after the first RFCA, especially in patients with NAFLD. Therefore, LSM values may be a valuable marker for risk stratification of AF recurrence after RFCA.