Key result
NAFLD linked to ~118% greater risk of AF recurrence after catheter ablation.
Why the study?
Retrospective studies suggest NAFLD increases post-ablation atrial arrhythmia recurrence, but prospective evidence is lacking.
Does nonalcoholic fatty liver disease increase the risk of atrial fibrillation recurrence after catheter ablation?
Cohort (n=106)
No
Does nonalcoholic fatty liver disease increase the risk of atrial fibrillation recurrence after catheter ablation?
Nonalcoholic fatty liver disease is an independent predictor of atrial fibrillation recurrence following catheter ablation, with advanced fibrosis further amplifying this risk.
Answers are grounded in this paper and cite their sources.
May inform post-ablation risk stratification in NAFLD; leaves open whether liver-directed therapy reduces recurrence.
Background Nonalcoholic fatty liver disease (NAFLD), prevalent in 25% globally, correlates with heightened cardiovascular risks. Retrospective studies suggest NAFLD increases post-ablation atrial arrhythmia recurrence, but prospective evidence is lacking. Methods This registered cohort study (ChiCTR2200059079) enrolled 106 AF ablation patients (53 NAFLD vs. 53 non-NAFLD). AF recurrence risk was assessed using multivariable Cox proportional hazards regression. NAFLD was diagnosed per American Association for the Study of Liver Diseases criteria, with fibrosis staged by FIB-4 (Fibrosis-4 index). Results NAFLD patients exhibited higher recurrence rates (49.1% vs. 24.5%, p = 0.022; annualized incidence: 48.1 vs. 24.0 per 100 person-years). Advanced fibrosis (FIB-4 > 1.30) amplified recurrence risk (71.4% vs. 34.4%, p = 0.024). Metabolic indices (BMI/glucose/lipids) did not independently predict outcomes. Conclusion NAFLD independently predicts AF recurrence post-ablation, with fibrosis severity stratifying risk. This underscores NAFLD management as a potential therapeutic target.
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Xu et al. (2026) conducted a cohort in Atrial fibrillation (n=106). Nonalcoholic fatty liver disease (NAFLD) vs. Non-NAFLD was evaluated on Atrial fibrillation recurrence (>30 s beyond the 3-month blanking period) (HR 2.177, 95% CI 1.100-4.312, p=0.026). Nonalcoholic fatty liver disease independently increased the risk of atrial fibrillation recurrence after catheter ablation by over twofold.
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