Predictive value of cardiac electrophysiological balance index for recurrent atrial fibrillation after ablation.

Objective: This study aimed to evaluate the prognostic significance of the cardiac electrophysiological balance index in predicting the recurrence of atrial fibrillation following radiofrequency ablation.

Methods: Patients with paroxysmal atrial fibrillation undergoing radiofrequency ablation were enrolled from July 2021 to March 2023 and categorized into recurrence and non-recurrence groups based on postoperative atrial fibrillation recurrence during a 6- to 12-month follow-up. Clinical and electrocardiogram data at admission were collected, and cardiac electrophysiological balance index was calculated. Multivariate logistic regression analysis identified independent factors contributing to atrial fibrillation recurrence. Receiver operating characteristic curves assessed predictive values.

Results: Among 127 subjects, 36 experienced postoperative recurrence (22 paroxysmal atrial fibrillation, 10 atrial flutter, and 4 atrial tachycardia). Significant differences in hypersensitive C-reactive protein levels, QT, QRS, and cardiac electrophysiological balance index were observed between recurrent and non-recurrent groups. Multivariate analysis revealed cardiac electrophysiological balance index as an independent risk factor for recurrence (OR 1.766, 95%CI 1.415-2.204, p<0.001). Receiver operating characteristic curve analysis showed cardiac electrophysiological balance index's predictive value with an area under the curve of 0.865 (95%CI 0.807-0.923, p<0.001), and a cutoff value of 4.3 demonstrated a sensitivity of 87.67% and a specificity of 71.23%.

Conclusions: The cardiac electrophysiological balance index emerges as a non-invasive tool with substantial predictive value for estimating the likelihood of paroxysmal AF recurrence post-ablation.