ArticleHeart rhythm O22026
Combined assessment of nonalcoholic fatty liver disease fibrosis score and B-type natriuretic peptide for predicting atrial fibrillation recurrence after catheter ablation: A multicenter study.
Article in Heart rhythm O2, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Combined assessment of the left and right atrial overload has been associated with atrial fibrillation recurrence after catheter ablation. Objective: This study aimed to investigate whether liver fibrosis scores are associated with right atrial remodeling and evaluate the prognostic value of combining these scores with B-type natriuretic peptide (BNP) levels. Methods: This study included a retrospective single-center cohort (n = 212) and a prospective multicenter validation cohort (n = 250) of patients who underwent first-time ablation for atrial fibrillation. Liver fibrosis scores, including the nonalcoholic fatty liver disease fibrosis score (NFS), fibrosis-4 index, and aspartate aminotransferase-to-platelet ratio index, were calculated before the procedure. The right atrial volume was assessed using 3-dimensional computed tomography. Results: NFS was significantly associated with atrial arrhythmia recurrence after catheter ablation, whereas the fibrosis-4 index and aspartate aminotransferase-to-platelet ratio index were not. Adding NFS to BNP further enhanced risk prediction. The patients were stratified into 3 groups based on the median NFS and BNP values to ensure balanced group sizes. Patients with elevated levels of both (group C) exhibited the worst clinical profiles and the highest recurrence rates. Group C was independently associated with atrial arrhythmia recurrence (hazard ratio, 3.07; 95% confidence interval, 1.07-8.77; Conclusion: The combined assessment of NFS and BNP enables noninvasive risk stratification by capturing biatrial overload and may help identify high-risk patients.
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