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May 19, 2026BMC Cardiovascular Disorders0 citationsOpen Access

Consistency between recurrent risk perception and objective recurrence risk in patients after atrial fibrillation ablation: a cross-sectional study

GXGuangdi XiMSMin ShanYDYaoyao Ding

Key Result

In patients after atrial fibrillation ablation, 38.31% underestimated their recurrence risk, a misperception significantly associated with lower social support (OR 0.519).

Key Points

  • The study evaluates how well patients' perceptions of their risk of afib recurrence match the actual estimated risk after ablation.
  • Included 210 hospitalized patients who underwent AF ablation across two hospitals.
  • Measured risk perception with a single question and used the APPLE score for estimated risk.
  • Used multinomial logistic regression to analyze factors affecting risk perception accuracy.
  • 38.31% of patients underestimated their AF recurrence risk, while 28.72% overestimated it.
  • Lower social support (OR = 0.519) and indifferent attitudes were linked to underestimating risk (p < 0.001).
  • Increased anxiety (OR = 2.065) and worsened daily living abilities (OR = 12.614) were associated with overestimating risk.

Study Design

Type

Cross-Sectional (n=210)

Multicenter

Yes

Structured PICO

P
Population
210 hospitalized patients who underwent atrial fibrillation (AF) ablation in two tertiary care hospitals in Qingdao
O
Outcome
Consistency between patients' recurrent risk perception and APPLE-estimated recurrence riskpatient reported

A significant proportion of patients post-AF ablation have inaccurate perceptions of their recurrence risk, with underestimation linked to low social support and overestimation linked to anxiety.

Main Result

Effect estimate: OR 0.519 (95% CI 0.393-0.686)

p-value: p=<0.001

Limitations

  • Exclusion of 22 participants (10.5%) who answered 'unknown' may introduce selection bias, as this group likely represents patients with lower health literacy or high decisional conflict.

Abstract

Objective This study aimed to evaluate the consistency between the patients’ recurrent risk perception and APPLE-estimated recurrence risk after atrial fibrillation (AF) ablation and to investigate the factors possibly contributing to the inconsistency between them. Methods This study included 210 hospitalized patients who underwent AF ablation in the cardiology departments of two tertiary care hospitals in Qingdao. We utilized a single question to measure AF recurrence risk perception of the participants; and the APPLE score served as a robust metric for assessing their APPLE-estimated recurrence risk. The accuracy of AF recurrence risk perception was calculated via comparing recurrence risk perception against APPLE-estimated recurrence risk and was then classified into three categories: “underestimated”, “accurate,” and “overestimated”. Additionally, logistic regression analysis was employed to examine the factors that may contribute to patients’ inaccurate perception of their recurrence risk. Results Our consistency analysis showed that 38.31% of patients underestimated their AF recurrence risk, while 28.72% overestimated it. Multinomial logistic regression analyses demonstrated that individuals with lower social support (OR = 0.519; 95% CI: 0.393–0.686; p < 0.001) and an indifferent attitude towards AF recurrence (OR = 0.028; 95%CI: 0.005–0.152; p < 0.001) were more likely to underestimate their risk. In contrast, those with increased levels of anxiety (OR = 2.065; 95%CI: 1.423–2.996; p < 0.001), diminished ability to perform activities of daily living(OR = 12.614; 95%CI: 3.146–50.574; p < 0.001), and worry about recurrent AF(OR = 7.978; 95%CI: 1.306–48.742; p = 0.025)demonstrated a greater tendency to overestimate their risk. Conclusions This study showed that many participants after AF ablation had inaccurate perceptions of their AF recurrence risk. Among them, those who underestimated the risk accounted for a large proportion, factors associated with low social support and an indifferent attitude towards AF recurrence.

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Cite This Study

Xi et al. (2026) conducted a cross-sectional in Atrial fibrillation (n=210). In patients after atrial fibrillation ablation, 38.31% underestimated their recurrence risk, a misperception significantly associated with lower social support (OR 0.519).

synapsesocial.com/papers/6a0bfe96166b51b53d379797https://doi.org/10.1186/s12872-026-05986-4
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