{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T14:49:07Z","timestamp":1776264547485,"version":"3.50.1"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early recurrence of atrial tachyarrhythmia (ERAF) after radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) remains a major clinical challenge. While left atrial diameter (LAD) is a known predictor, the role of atrial mechanical function, particularly left atrial appendage emptying velocity (LAAEV), and its integration with other markers needs clarification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective cohort study included 157 drug-refractory non-valvular AF patients undergoing first-time RFCA. Among them, 53 (33.8%) developed ERAF within the 90-day blanking period. Baseline clinical, echocardiographic (including LAD and LAAEV), and biochemical (NT-proBNP) data were collected. The primary endpoint was ERAF (atrial tachycardia\/flutter\/fibrillation \u226530\u2005s) within the 90-day blanking period. Predictive models were developed using logistic regression. An integrative AF Recurrence Index (AF-RI) was derived and validated internally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 157 patients, 53 (33.8%) experienced ERAF. The ERAF group exhibited a distinct \u201catrial failure\u201d phenotype: larger LAD (43.8\u2009\u00b1\u20095.6 vs. 39.5\u2009\u00b1\u20094.3\u2005mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), lower LAAEV (35.8\u2009\u00b1\u20099.9 vs. 47.6\u2009\u00b1\u200911.9\u2005cm\/s,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and higher NT-proBNP (median 356.9 vs. 207.2\u2005pg\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023). LAAEV was a stronger independent predictor (AUC: 0.812, 95% CI: 0.742\u20130.882) than LAD (AUC: 0.745, 95% CI: 0.665\u20130.825). The AF-RI, integrating LAD, LAAEV, and NT-proBNP, demonstrated outstanding discrimination (AUC: 0.917, 95% CI: 0.874\u20130.960), with significantly higher sensitivity (88.7%) and specificity (84.6%) than single-parameter models (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Correlation network analysis positioned LAAEV as a central hub linking structural and neurohormonal remodeling. Patients stratified by LAAEV tertiles showed dramatically graded ERAF risks (14.8%, 28.3%, 58.5%,\n                      <jats:italic>p<\/jats:italic>\n                      -trend\u2009&amp;lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      LAAEV is a potent, independent predictor of ERAF, central to an \u201catrial failure\u201d phenotype. The integrative AF-RI score provides a simple, bedside-friendly tool for individualized risk stratification, enabling clinicians to identify high-risk patients (e.g., those with LAAEV\u2009&amp;lt;\n                      <jats:sans-serif>\u200935<\/jats:sans-serif>\n                      \u2005cm\/s) who may benefit from intensified monitoring or tailored therapeutic strategies post-ablation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1769676","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T13:54:51Z","timestamp":1776261291000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["LAAEV-centric atrial failure phenotype and a novel integrative score for predicting early recurrence after AF ablation"],"prefix":"10.3389","volume":"13","author":[{"given":"Rui","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Xingtai People\u2019s Hospital Affiliated to Hebei Medical University","place":["Xingtai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruixue","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology VIII, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lianxia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology I, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jidong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European association for cardio-thoracic surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European heart rhythm association (EHRA) of the 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