To observe the significance of left atrial (LA) function combined with B-type natriuretic peptide (BNP) in predicting the recurrence of paroxysmal atrial fibrillation (PAF) after cardiopulmonary vein ablation (CPVA).

A total of 201 PAF patients from Changzhou NO.1 People's Hospital who planned to receive the first CPVA operation were selected. According to the results of dynamic electrocardiogram 3 months after CPVA, AF patients were divided into either a sinus rhythm group or a recurrence group. Multivariate logistic regression analysis was performed to analyze the independent factors influencing the recurrence of PAF after CPVA. Receiver operating characteristic (ROC) curve analysis was used to compare the diagnostic efficiency of each index.

Of the 201 AF patients who underwent CPVA, 36 (17.9%) experienced recurrent AF during follow-up. BNP in the recurrence group was significantly higher than that of the sinus rhythm group (P＜0.05). There were significant differences in LA minimum volume index (LAVImin), LA maximum volume index (LAVImax), expansion index (EI), diastolic ejection index (DEI), passive ejection index (PEI), and active ejection index (AEI) between the two groups P＜0.05 for all). Multivariate logistic regression analysis showed that BNP, DEI, and history of PAF were independent predictors of AF recurrence (P＜0.05). ROC curve analysis showed that the areas under the ROC curves (AUCs) of DEI and combination index (DEI+BNP) were both better than LAVImin (AUC: 0.881 vs 0.686, 0.901 vs 0.686, P＜0.05 for both), and the specificity of the combination index (DEI+BNP) was better than either of them alone (89.7% vs 79.4%, 89.7% vs 72.7%, P＜0.05 for both).

In patients with PAF treated by CPVA, impaired LA storage function and increased BNP are independent predictors of AF recurrence after CPVA. The combination of the two can improve the specificity of diagnosis.