A prediction model based on functional mitral regurgitation for the recurrence of paroxysmal atrial fibrillation(PAF) after post-circular pulmonary vein radiofrequency ablation (CPVA)
Jingyu Sheng1,2, Zhenni Yang2, Min Xu2, JunMeng2, Mingxia Gong2, Yuxia Miao2, Ling Yang2
1Department of Electrocardiography, Wujin Hospital Affiliated with Jiangsu University, The Wujin Clinical college of Xuzhou Medical University, Changzhou, China;
2Department of Cardiovascular Division, the Third Affiliated Hospital of Soochow University, Chang Zhou, China;
Correspondence to: Min Xu and Ling yang, Department of Cardiovascular Division, the Third Affiliated Hospital of Soochow University, Chang Zhou 213003, China;Email: loisicelin@163.com and linda_yl@sina.com.
Jingyu Sheng and Zhenni Yang are the first coauthors and contributed equally to this work.
  1. The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available dute to privacy or ethical restrictions.
  2. Funding: The Changzhou City Technology Bureau has no role in this study.
  3. Conflict of Interest statement All the authors do not have any conflicts of interest. 3.Ethical Statement This study was in compliance with the ”Declaration of Helsinki” and was approved by the Scientific Ethics Committee of Soochow University.
4.Acknowledgement
This work was supported by National Natural Science Foundation of China (Grant No. 82070405); National Natural Science Foundation of China (Grant No. 81471690); Changzhou City Technology Bureau (CJ20190086).
5.Informed consents of all patients were obtained from the patients themselves.
6.Conflict of Interest Disclosure
All authors declare that: (1) they have not received any support from any organization having an interest in the submitted works, whether financial or otherwise; (2) there are no other relationships or activities that may affect the submitted works.
【Abstract】Aim To construct a prediction model based on functional mitral regurgitation (FMR) in patients with paroxysmal atrial fibrillation (PAF) for predicting atrial fibrillation recurrence after the post-circular pulmonary vein radiofrequency ablation (CPVA).Methods We retrospectively analyzed 289 patients with PAF who underwent CPVA for the first time . The patients were randomly divided into modeling group and verification group at the ratio of 75:25. In the modeling group, the multivariate logistic regression was used to analyze and construct a prediction model for post-CPVA recurrence in PAF patients, which was then validated in the verification group.Results (1) After 3-6 months of follow-up, the patients were divided into sinus rhythm group (252 cases) and recurrence group (24 cases); (2) In the modeling group, the age, LAD(left atrial diameter) and degree of MR (mild, moderate, severe) were higher in recurrence group than that of the sinus rhythm group, and the left atrial appendage emptying velocity (LAAV) was lower in recurrence group (allP <0.05). (3) A model for predicting the recurrence of PAF after radiofrequency ablation was constructed in the modeling group. The equation was: Logit(P) = -3.253 + 0.092 × age + 1.263 × mild MR + 2.325 × moderate MR + 5.111 ×severe MR - 0.113 × LAAV. The area under the curve (AUC) of the model was 0.889 in modeling group and 0.866 in verification group, and the difference was not statistically significant (P >0.05).
Conclusion: The prediction model of atrial fibrillation (AF) recurrence after CPVA in PAF patients has good predictive efficacy, high specificity and accuracy.
Key words: atrial fibrillation, prediction model, circular pulmonary vein radiofrequency ablation, echocardiography, recurrence