ArticlePacing and clinical electrophysiology : PACE2026
NT-proBNP as a Predictor of Atrial Fibrillation Recurrence After Cryoballoon, Radiofrequency and Pulsed-Field Ablation.
Article in Pacing and clinical electrophysiology : PACE, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03718364 (Swiss Atrial Fibrillation Pulmonary Vein Isolation Registry), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Swiss Atrial Fibrillation Pulmonary Vein Isolation Registry
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12 authors.
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Abstract
introductionNatriuretic peptides have shown to predict atrial fibrillation (AF) ablation success using thermal energies. Pulsed-field ablation (PFA) is a novel AF ablation technology. This study investigates the predictive value of NT-proBNP and clinical parameters for pulmonary vein isolation (PVI) success using PFA, cryoballoon ablation (CBA), and radiofrequency ablation (RFA).
methodsWe included all patients undergoing primary PVI between May 2019 and December 2023 from our prospective registry, excluding those in randomized trials or without NT-proBNP measured ≤1 day before the procedure. Follow-up included 7-day Holter-ECGs at 3, 6, and 12 months. The primary endpoint was atrial arrhythmia recurrence between days 90-365. NT-proBNP was dichotomized using the age- and sex-adjusted 95th percentile in healthy adults.
resultsAmong 1,391 patients (median age 67 years; 29% female) undergoing primary PVI with RFA (n = 302), CBA (n = 399), or PFA (n = 690), elevated NT-proBNP levels were observed in 55%, with no significant differences between ablation modalities. NT-proBNP correlated with age and left atrial volume and was higher in patients with persistent AF. Overall, 1-year arrhythmia recurrence rate was 32.1%, without differences between ablation technologies. Elevated NT-proBNP was associated with recurrence across all subgroups. In multivariate Cox regression, NT-proBNP and persistent AF were the strongest independent predictors of recurrence. A simplified model including only NT-proBNP and AF type yielded a concordance index of 0.62.
conclusionsNT-proBNP is a robust predictor of atrial arrhythmia recurrence after PVI, independent of the ablation technology, and may support shared, evidence-based decision-making with patients regarding ablation success probability.
trial registrationThe Swiss-AF-PVI registry is registered with ClinicalTrials.gov (NCT03718364).
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