What does this research mean for the field?

The ALDH2-AA genotype is an independent predictor of atrial fibrillation recurrence after radiofrequency catheter ablation, with an adjusted hazard ratio of 2.43. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to explore the relationship between ALDH2 gene polymorphisms and the recurrence of atrial fibrillation after radiofrequency catheter ablation, focusing on metabolic changes.

February 8, 2026

ALDH2 gene polymorphisms and metabolite alterations in the recurrence of atrial fibrillation after radiofrequency catheter ablations: a prospective and multicenter study

Key Result

ALDH2-AA genotype independently increases the risk of AF recurrence after RFCA by 2.43-fold (HR 2.43, 95% CI 1.10-5.36, p=0.028) compared to other genotypes.

Key Points

This study aims to explore the relationship between ALDH2 gene polymorphisms and the recurrence of atrial fibrillation after radiofrequency catheter ablation, focusing on metabolic changes.
Enrolled 309 patients with new-onset atrial fibrillation in three medical centers.
Categorized patients into three groups based on ALDH2 genotypes.
Used Cox regression models to identify predictors of AF recurrence after ablation.
Collected plasma samples to analyze differential metabolites among genotypes.
Found a 22.33% rate of AF recurrence post-ablation over a median follow-up of 10.63 months.
ALDH2-AA genotype exhibited the highest recurrence rate, identified as an independent predictor.
Identified 16 different metabolites, with L-Glutamine being significantly higher in ALDH2-AA patients.

Structured PICO

Does the ALDH2-AA genotype predict atrial fibrillation recurrence in patients with new-onset AF undergoing radiofrequency catheter ablation?

Population

309 patients with new-onset atrial fibrillation undergoing radiofrequency catheter ablation across three medical centers

Intervention

ALDH2-AA genotype

Comparator

Other ALDH2 genotypes

Outcome

Atrial fibrillation recurrence after radiofrequency catheter ablationhard clinical

The ALDH2-AA genotype significantly increases the risk of atrial fibrillation recurrence after radiofrequency catheter ablation and is associated with elevated L-Glutamine levels.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Background The association between acetaldehyde dehydrogenase 2 (ALDH2) polymorphisms and atrial fibrillation (AF) remains controversial. Objectives To investigate whether ALDH2 polymorphisms were associated with AF recurrence after radiofrequency catheter ablation (RFCA), including changes in underlying metabolites. Methods A total of 309 patients with new-onset AF, scheduled for follow-up in three medical centers, were prospectively enrolled. Patients were categorized into three groups based on ALDH2 genotypes. Multiple Cox regression models were used to identify predictors of AF recurrence after RFCA. 27 plasma samples were collected from patients before RFCA procedures to examine differential metabolites and metabolic pathways among ALDH2 polymorphisms. Results There were 69 (22.33%) cases of AF recurrence after RFCA during a median follow-up of 10.63 months interquartile range: 4.57-12.00. Kaplan-Meier analysis showed that patients with ALDH2-AA genotype had the highest recurrence rate (Log rank P=0.031). The ALDH2-AA genotype was the independent predictor of AF recurrence from multivariable Cox regression analysis by adjusting for different risk factors (adjusted HR: 2.43, 95% CI, 1.10-5.36, p=0.028). 16 metabolites in plasma samples were found to reflect metabolic differences from patients undergoing RFCA procedures among ALDH2 polymorphisms (variable importance in projection ≥ 1, P ≤ 0.05). ALDH2-AA genotype experienced the highest levels of L-Glutamine. Conclusion ALDH2-AA genotype was significantly associated AF recurrence after RFCA. The addition of ALDH2 genotypes into conventional risk factors significantly improves the ability to predict risk of AF recurrence after RFCA. L-Glutamine might be the main metabolite that distinguishes patients with the ALDH2-AA genotype.

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