Comment:
Clinical recommendations for patients with atrial fibrillation (AF) advise radiofrequency catheter ablation (RFCA) for symptom management and cardiovascular outcome improvement. However, approximately 50% of AF patients are affected by recurrent arrhythmia within 5 years of RFCA. While it is known that non-alcoholic fatty liver disease (NAFLD) is an independent risk factor for arrhythmia recurrence after RFCA, the association between liver fibrosis level and AF recurrence after ablation has not been characterised.
This study aimed to examine the association between advanced liver fibrosis and recurrence of AF after RFCA in patients with NAFLD.
Key learnings:
High-risk categories of FIB-4 and NFS indexes for advanced liver fibrosis were independently associated with AF recurrence after RFCA. These indexes could thus be effective predictors for AF recurrence in NAFLD patients. Similarly, high-risk categories of FIB-4 and NFS were also associated with AF type (persistent AF) and duration (≥ 3 years). This supports the finding that advanced liver fibrosis represents an independent risk factor for AF recurrence after ablation. This may be meaningful for clinical risk stratification in AF patients who have undergone ablation.
Other risk factors for AF recurrence post-ablation include left atrial diameter (LAD), metabolic syndrome and insulin resistance.
