ArticleMedicine2026
J-shape positive association between E/E' and recurrent atrial fibrillation after radio-frequency catheter ablation: A cohort study in China.
Article in Medicine, 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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7 authors.
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Abstract
The relationship between E/E' and recurrent atrial fibrillation (AF) after radio-frequency catheter ablation (RFCA) remains unclear. This study aimed to investigate the association between the E/E' ratio and recurrent AF after RFCA. A cohort of 278 AF patients undergoing RFCA at the Second Hospital of Hebei Medical University from January 2017 was consecutively enrolled. Baseline clinical and demographic data were collected, with follow-ups (planned: 3, 6, 12, 18 months and every 6 months thereafter; unplanned: symptom-triggered) using 12-lead electrocardiography and 24-hour Holter monitoring to detect recurrent AF (primary endpoint, defined as AF/atrial flutter/tachycardia lasting ≥30 seconds after a 3-month blanking period). Kaplan-Meier analysis estimated recurrent rates; multivariate Cox regression and generalized additive models explored associations between E/E' and recurrent AF, including nonlinear relationships. Over a median follow-up of 15 months, 24.82% of patients developed recurrent AF. The recurrent rate was significantly higher in the high E/E' group (P < .01). After adjustment, the high E/E' group had a 4-fold higher risk of recurrent AF (hazard ratio [HR] = 4.01, 95% confidence interval: 2.12-7.57, P < .01). A J-shaped association was identified, with an inflection point at 10.10: elevated E/E' below 10.10 was not significantly associated with recurrent risk, while each 1-unit increase in E/E' above 10.10 was associated with an 18% higher adjusted HR (HR = 1.18, 95% confidence interval: 1.10-1.26, P < .01). High E/E' was associated with a higher rate of recurrent AF after RFCA. A significant positive association was observed between E/E' and recurrent AF, particularly when E/E' ≥ 10.10.
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