What type of study is this?

This is a Validation Study study.

What does this research mean for the field?

A nomogram predicting atrial fibrillation recurrence after radiofrequency catheter ablation demonstrates good discrimination with a C-index of 0.895, utilizing key variables such as left atrial volume and NYHA classification. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aims to create and validate a risk model for predicting recurrence of atrial fibrillation after radiofrequency catheter ablation.

January 10, 2026BMC Medical Informatics and Decision Making0 citationsOpen Access

Development and validation of a risk nomogram for predicting recurrence in patients with non-valvular atrial fibrillation after radiofrequency catheter ablation

YYYi YuShanghai Chest Hospital JCJinlan ChenZhejiang Chinese Medical University GLGang LiHarbin Medical University

Key Result

A nomogram predicting AF recurrence after RFCA demonstrated good discrimination (C-index 0.895) with key variables including left atrial volume and NYHA classification.

Key Points

The study aims to create and validate a risk model for predicting recurrence of atrial fibrillation after radiofrequency catheter ablation.
Enrolled 242 patients with non-valvular atrial fibrillation.
Divided participants into modeling (n=169) and validation (n=73) groups.
Used echocardiographic parameters, laboratory values, and clinical features to build a predictive model.
Applied univariate and multivariate logistic regression analyses to identify risk factors.
Developed an online nomogram tool for risk estimation.
87 out of 242 patients (36.00%) experienced atrial fibrillation recurrence within one year.
The nomogram included five significant variables: left atrial volume index, right atrial volume index, systemic immune-inflammatory index, NYHA classification, and CHA₂DS₂-VASc score.
Achieved a C-index of 0.837 in the training cohort and 0.895 in the validation cohort, indicating strong predictive accuracy.
Demonstrated good calibration and clinical utility through decision curve analysis.

Structured PICO

Population

242 patients with non-valvular atrial fibrillation (NVAF) who underwent successful radiofrequency catheter ablation (RFCA), aged 45 to 80 years (mean age 69.10, 55.40% male). Exclusions included implantable cardioverter-defibrillator, cardiomyopathy, history of tumor, AF secondary to valve disease, and severe renal insufficiency.

Intervention

Radiofrequency catheter ablation (circumferential pulmonary vein isolation) followed by risk stratification using a novel nomogram incorporating LAVI, RAVI, SII, NYHA classification, and CHA₂DS₂-VASc score

Outcome

Atrial fibrillation recurrence (defined as any atrial tachyarrhythmias including AF, atrial flutter, and atrial tachycardia lasting over 30 seconds more than 3 months after the ablation) at 1-year follow-up

A novel nomogram incorporating echocardiographic (LAVI, RAVI), clinical (NYHA, CHA₂DS₂-VASc), and inflammatory (SII) markers provides high discriminative accuracy for predicting 1-year AF recurrence after radiofrequency catheter ablation.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Limited evidence exists regarding predictors of recurrence in patients with non-valvular atrial fibrillation (NVAF) following radiofrequency catheter ablation (RFCA). This study aimed to develop and validate a risk model for post-ablation recurrence in these patients. 242 patients were enrolled and randomly divided into a modeling group ( n = 169) and a validation group ( n = 73) according to 7:3. The echocardiographic parameters, laboratory values and clinical features were used to derive a predictive model. Univariate and multivariate logistic regression analyses were used to identify independent risk factors. During the 1-year follow-up, 87(36.00%) patients experienced AF recurrence. The nomogram was established by five variables including left atrial volume index (OR1.055, 95% CI: 1.021–1.090, P = 0.001), right atrial volume index (OR1.040, 95% CI: 1.008–1.073, P = 0.014), systemic immune-inflammatory index(OR1.015, 95% CI: 1.001–1.030, P = 0.036), New York Heart Association classification (OR 2.861, 95% CI: 1.282–6.383, P = 0.010), and CHA₂DS₂-VASc score(OR1.417, 95% CI: 1.077–1.864, P = 0.013). The model was developed, an online Dynamic Nomogram ( https://cardiologyresearch.shinyapps.io/DynNomapp ) application via the platform, and subsequently validated. The calculator achieved a C-index of 0.837(95% Cl: 0.774–0.899) in the training cohort and 0.895 (95% Cl: 0.823–0.968) in the validation cohort. The calibration curve showed good consistency between the predictions and observations in the training and validation cohorts. Decision curve analysis and clinical impact curves indicated the clinical utility of the nomogram. We developed a nomogram based on LAVI, RAVI, SII, NYHA classification, CHA₂DS₂-VASc score to estimate the risk of AF recurrence after RFCA. The newly developed nomogram demonstrated good discrimination and accuracy, suggesting its potential utility in predicting AF recurrence. Given its performance, the model is a promising tool; however, it is still in its preliminary stages and requires further validation with larger, multi-center, prospective studies involving diverse populations to confirm its generalizability.

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