What does this research mean for the field?

Patients with metabolic syndrome have an 8-fold increased risk of atrial fibrillation recurrence after pulmonary vein isolation compared to those without metabolic syndrome. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To assess the relationship between metabolic syndrome, epicardial fat thickness, and serum biomarkers with atrial fibrillation recurrence.

February 8, 2026

Predictors of atrial fibrillation recurrence after radiofrequency pulmonary vein isolation: metabolic syndrome, epicardial fat thickness, what else?

Key Result

Metabolic syndrome increased AF recurrence risk 8-fold, epicardial fat ≥4.5mm raised it 1.32-fold, and galectin-3 ≥0.77ng/ml raised it 5.65-fold after PVI.

Key Points

To assess the relationship between metabolic syndrome, epicardial fat thickness, and serum biomarkers with atrial fibrillation recurrence.
Examined 95 patients with atrial fibrillation post-radiofrequency pulmonary vein isolation
Assessed metabolic syndrome based on International Diabetes Federation criteria
Measured epicardial fat thickness via echocardiography
Analyzed serum levels of galectin-3 and TGF-b1 using ELISA
Used logistic regression and ROC analysis for statistical evaluation.
80.6% of patients with atrial fibrillation recurrence had metabolic syndrome compared to 33.9% without recurrence
Epicardial fat thickness averaged 5.8 mm in patients with recurrence versus 4.9 mm without recurrence (p = 0.0187)
Higher galectin-3 levels (0.85 ng/ml vs 0.72 ng/ml, p = 0.01) linked to recurrence
8-fold increased risk of atrial fibrillation recurrence in patients with metabolic syndrome (p = 0.001)
Threshold values for epicardial fat thickness and galectin-3 correlate with increased recurrence risk.

Structured PICO

Do metabolic syndrome, epicardial fat thickness, and galectin-3 levels predict atrial fibrillation recurrence after pulmonary vein isolation in patients with paroxysmal atrial fibrillation?

Population

95 patients with paroxysmal atrial fibrillation who underwent radiofrequency pulmonary vein isolation due to ineffectiveness of antiarrhythmic therapy, average age 54.2 ± 8.2 years.

Intervention

Assessment of metabolic syndrome, epicardial fat thickness, and serum galectin-3 and TGF-b1 levels

Outcome

Atrial fibrillation recurrence after one year of prospective post-PVI observationhard clinical

Metabolic syndrome, increased epicardial fat thickness, and elevated galectin-3 levels are independent predictors of atrial fibrillation recurrence after radiofrequency pulmonary vein isolation.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Aim To establish association of metabolic syndrome (MS), epicardial fat thickness (EFT), concentration of galectin-3 and transforming growth factor-beta1 (TGF-b1) in blood serum with atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). Materials and methods Ninety five (n = 95) of 258 examined patients with AF underwent PVI due to ineffectiveness of the antiarrhythmic therapy. Average patient age was 54.2 ± 8.2 years. MS was diagnosed according to International Diabetes Federation (IDF) criteria. EFT was detected by means of transthoracic echocardiography. Galectin-3 and TGF-b1 serum levels were determined by enzyme-linked immunosorbent assay (ELISA). Results After one year of prospective post-PVI observation all patients were divided into 2 groups: Group I included 59 patients (62.1%) without arrhythmia recurrence, and Group II comprised 36 patients (37.9%) with AF recurrence. MS prevalence reached 80.6% among patients with AF relapse and only 33.9% – in patients without AFrecurrence. EFT in patients with AF recurrence was greater than in patients without AF recurrence (5.8 ± 1.8 mm and 4.9 ± 1.9 mm, p = 0.0187). Galectin-3 concentration in patients with AF recurrence was higher than in patients without AF recurrence (0.85 0.68; 0.96 ng / ml and 0.72 0.62; 0.85 ng / ml, p = 0.01). The concentration of TGF-b1 did not significantly differ in patients with and without AF recurrence (3586.9 1841.0; 5545.8 pg/ml and 2581.3 1896.4; 3177.4 pg/ml, p = 0.21). Logistic regression method allowed us to establish that the risk of AF recurrence after PVI was 8-hold higher in patients with MS (OS = 8.08, 95% CI 3.01-21.65; p = 0.001). According to the ROC analysis, the EFT threshold value of 4.5 mm or more (AUC = 0.653 ± 0.059, p = 0.014) increases the likelihood of AF recurrence after PVI by 1.32-fold (OR = 1.316 95% CI 1.053-1.645; p = 0.016 ); galectin-3 concentration level 0.77 ng/ml or more (AUC = 0.646 ± 0.060, p = 0.019) increases the risk of AF recurrence after PVI by 5.65-fold (OR = 5.65, 95% CI 1.153-27.762 ; p = 0.033). The change in TGF-b1 concentration did not affect AF recurrence. Conclusion Metabolic syndrome presence, high epicardial fat thickness and elevated level of galectin-3 serum concentration are independent predictors of ineffectiveness of radiofrequency pulmonary vein isolation in patients with paroxysmal atrial fibrillation.

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