Tumor Necrosis Factor Superfamily 14: A Potential Predictor of Atrial Fibrillation Recurrence After Catheter Ablation

Background Tumor necrosis factor superfamily 14 (TNFSF14) has been implicated in the pathogenesis of cardiovascular disease, including atrial fibrillation (AF). However, its role in predicting AF recurrence after catheter ablation (CA) remains unexplored. Objective This study aimed to evaluate the predictive value of TNFSF14 for AF recurrence post‐ablation. Methods A total of 263 AF patients undergoing CA were enrolled and stratified into two groups based on AF recurrence during a mean follow‐up of 363 ± 144 days. Plasma TNFSF14 levels were measured by enzyme‐linked immunosorbent assay (ELISA). Cox proportional hazards models were employed to examine the association between TNFSF14 levels and AF recurrence, while Receiver Operating Characteristic (ROC) analysis was used to assess predictive performance. Results AF recurrence occurred in 81 patients (30.8%). Patients with recurrence exhibited significantly higher baseline TNFSF14 levels (1.21 ± 0.24 vs. 1.02 ± 0.29 ng/mL, p < 0.001). Elevated TNFSF14 levels were independently associated with AF recurrence (Adjusted hazard ratio (aHR): 3.65, 95% CI: 2.19–6.09, p < 0.001). ROC analysis demonstrated moderate predictive power for TNFSF14 (AUC: 0.70). Incorporating TNFSF14 levels into the ATLAS score and BNP significantly enhanced the predictive performance for recurrence, as evidenced by improved time‐dependent AUC, decision curve analysis, net reclassification improvement (NRI: 0.36, p < 0.001) and integrated discrimination improvement (IDI: 0.08, p = 0.012). Conclusions TNFSF14 is a promising biomarker for predicting AF recurrence after CA. It holds potential for inclusion in future personalized risk models for AF recurrence.