Sisk prediction scheme for recurrence of atrial fibrillation after cryoballoon catheter ablation

Zhang Longfei; Cui Yingkai; Zhang Zhao; Bi Zexian

doi:10.3969/j.issn.1674-4055.2025.08.12

Abstract：Objective To analyze deeply the risk factors for post-operation recurrence of atrial fibrillation(AF)after cryoballoon catheter ablation(CBCA),and based on which to establish a nomogram model for effectively predicting recurrence risk.Methods A retrospective analysis was conducted on the clinical data of 263 patients with atrial fibrillation(AF)who underwent CBCA at the Hospital of 82nd Group Army PLA from Mar.2020 to May 2023.According to the recurrence status of the patients during the 1-year follow-up after surgery,the patients were divided into a recurrence group(n=74)and a non-recurrence group(n=189).The clinical data were compared to analyze the factors influencing AF recurrence after CBCA in 2 groups.Based on the results,a nomogram model for risk prediction was constructed.The Bootstrap resampling technique was used to validate the constructed nomogram model,and a calibration curve and a receiver operating characteristic(ROC)curve were plotted simultaneously to evaluate the calibration accuracy and potential predictive effectiveness of the nomogram.Results The age,levels of high-sensitivity C-reactive protein(hs-CRP)and uric acid(UA),and 60-second right superior pulmonary vein(RSPV)freezing temperature were all higher in recurrence group than those in non-recurrence group(P＜0.05).The disease duration and left atrial diameter(LAD)were also higher in recurrence group than those in non-recurrence group(P＜0.05).It can be concluded that advanced age,long disease duration,elevated levels of hs-CRP and UA,increased LAD,and increased 60-second RSPV freezing temperature were all risk factors for AF recurrence after CBCA(P＜0.05).A nomogram model for risk prediction was constructed based on the above influencing factors,and validated by using Bootstrap method.The concordance index(C-index)reached 0.846,and calibration curve showed a good fit with ideal curve.The results of ROC curve indicated that AUC for predicting postoperative recurrence was 0.904(95%CI:0.861～0.937),and sensitivity was 87.84%and specificity was 83.07%.Conclusion Age,disease duration,hs-CRP,UA,LAD and 60-second RSPV freezing temperature are all factors influencing AF recurrence after CBCA,and the nomogram model constructed based on above factors showed a higher value in clinical application,which can be provide effective reference for medical decision-making.