https://orcid.org/0000-0003-0178-1999
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Abstract
Purpose
This study aimed to develop and validate a risk nomogram model for predicting the risk of atrial fibrillation recurrence after radiofrequency catheter ablation.
Patients and Methods
A retrospective observational study was conducted using data from 485 patients with atrial fibrillation who underwent the first radiofrequency ablation in our hospital from January 2018 to June 2021. All patients were randomized into training cohort (70%; n=340) and validation cohort (30%; n=145). Univariate and multivariate logistic regression analyses were used to identify independent risk factors. The predictive nomogram model was established by using R software. The nomogram was developed and evaluated based on differentiation, calibration, and clinical efficacy by concordance statistic (C-statistic), calibration plots, and decision curve analysis (DCA), respectively.
Results
The nomogram was established by four variables including left atrial diameter (OR 1.057, 95% CI 1.010–1.107, P=0.018), left ventricular ejection fraction (OR 0.943, 95% CI 0.905–0.982, P=0.005), type of atrial fibrillation (OR 2.164, 95% CI: 1.262–3.714), and systemic inflammation score (OR 1.905, 95% CI 1.408–2.577). The C-statistic of the nomogram was 0.741 (95% CI: 0.689–0.794) in the training cohort and 0.750 (95% CI: 0.670–0.831) in the validation cohort. The calibration plots showed good agreement between the predictions and observations in the training and validation cohorts. Decision curve analysis and clinical impact curves indicated the clinical utility of the predictive nomogram.
Conclusion
The nomogram model has good discrimination and accuracy, which can screen high-risk groups intuitively and individually, and has a certain predictive value for atrial fibrillation recurrence in patients after radiofrequency ablation.
Ethics Statement
The study was conducted in accordance with the Declaration of Helsinki and has been approved by the Medical Ethics Committee of the Affiliated Hospital of Xuzhou Medical University. Due to the study being a retrospective analysis, the review committee waived the requirement for written informed consent. Confidential patient information was removed from the entire data set prior to analysis.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.