Key result
Elevated free fatty acids at 3 months post-ablation predict ~10-fold higher AF recurrence risk.
Why the study?
Free fatty acids are associated with cardiovascular diseases and cardiac arrhythmias, but whether they can predict AF recurrence after catheter ablation remained to be studied.
Do elevated free fatty acid levels predict atrial fibrillation recurrence after catheter ablation in patients with symptomatic paroxysmal or persistent AF?
Cohort (n=88)
No
Do elevated free fatty acid levels predict atrial fibrillation recurrence after catheter ablation in patients with symptomatic paroxysmal or persistent AF?
Effect estimate: HR 10.45 (95% CI 8.61-25.33)
Absolute Event Rate: 61.1% vs 0%
p-value: p=0.03
Elevated free fatty acid levels at 3 months post-ablation are a strong independent predictor of atrial fibrillation recurrence at 1 year.
May warrant closer monitoring in high-FFA patients; leaves open whether FFA modification reduces post-ablation recurrence.
Background: Free fatty acids (FFA) are promising biomarkers for the diagnosis and assessment of several diseases. They have been associated with cardiovascular diseases, such as insulin resistance, arteriosclerosis, myocardial dysfunction, cardiac arrhythmias, and sudden cardiac death; thus, it is important to study the relationship between FFA and atrial fibrillation (AF), especially whether FFAs can predict AF recurrence after catheter ablation. Methods: Patients with symptomatic paroxysmal or persistent AF undergoing radiofrequency catheter ablation for the first time were included in the study. Plasma FFA levels were measured upon admission and 3 months after ablation. Results: A total of 88 patients with AF (55 males, 33 females; mean age, 62.5 ± 8.7 years) were included for analysis. FFA levels upon admission in patients with paroxysmal and persistent AF were 0.38 ± 0.16 and 0.37 ± 0.15 mmol/L, respectively. During the 3-month follow-up after radiofrequency ablation, FFA concentration in patients with paroxysmal and persistent AF were 0.38 ± 0.18 and 0.36 ± 0.18 mmol/L, respectively. FFA concentration in patients with and without AF recurrence were 0.69 ± 0.07 and 0.33 ± 0.14 mmol/L, respectively. Kaplan–Meier analysis showed that AF recurrence was significantly higher in patients with FFA ≥0.53 mmol/L than in patients with FFA <0.53 mmol/L (p < 0.001). FFA concentration at 3 months post-ablation was an independent predictor of AF recurrence in patients who underwent catheter ablation (hazard ratio = 10.45, 95% CI [8.61–25.33], p = 0.03). Conclusion: Elevated postoperative FFA levels were closely related to AF recurrence at the 1-year follow-up, implying that postoperative FFA levels can be used as a predictive biomarker for AF recurrence. FFAs may be used as a new therapeutic target for the prevention and treatment of AF.
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Zhou et al. (2025) conducted a cohort in Atrial Fibrillation (n=88). Elevated free fatty acid levels (≥0.53 mmol/L) vs. Free fatty acid levels <0.53 mmol/L was evaluated on Atrial fibrillation recurrence (HR 10.45, 95% CI 8.61-25.33, p=0.03). Elevated free fatty acid levels at 3 months post-ablation independently predicted atrial fibrillation recurrence (HR 10.45).
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