ORIGINAL RESEARCH article
Front. Surg.
Sec. Cardiovascular Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1653123
Prediction of the Impact of Anxiety on Atrial Fibrillation (AF) Recurrence After Radiofrequency Catheter Ablation Based on Heart Rate Variability
Provisionally accepted
- 1Beijing Huilongguan Hospital, Beijing, China
- 2Beijing Changping District Huilongguan Community Health Service Center, Beijing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract Background Radiofrequency catheter ablation (RFCA) can significantly improve the prognosis of patients with atrial fibrillation (AF); however, the postoperative recurrence rate remains high. Therefore, identifying accurate predictors of recurrence after RFCA holds important clinical value. Methods This retrospective study included 180 patients with AF who underwent RFCA. Patients were grouped by one-year recurrence status. Univariate analysis was conducted to compare demographic and clinical characteristics between the two groups. Cox proportional hazards models and Kaplan–Meier survival curves were used to assess the impact of heart rate variability (HRV), anxiety, and their interaction on recurrence. Predictive performance was evaluated with receiver operating characteristic (ROC) curves. Stratified analyses were performed to explore whether the effect of anxiety on recurrence varied by HRV levels. Results Compared with the non-recurrence group, the recurrence group had higher prevalence of persistent AF and heart failure, longer AF duration, and more severe left atrial structural burden (i.e., higher EFT, LAD, and LAVI values). Multivariate Cox analysis identified that both HRV and anxiety were independent risk factors for recurrence, and their interaction term also had significant predictive value (HR > 1, P < 0.05). Kaplan–Meier analysis indicated that patients with low HRV and high anxiety had the lowest recurrence-free survival rate. ROC curve analysis revealed that the combined HRV-anxiety interaction model yielded an AUC of 0.745, indicating a certain predictive advantage over individual indicators. Stratified analysis further confirmed that the recurrence risk associated with high anxiety was more pronounced in the low HRV group. Conclusion HRV and anxiety were identified as independent predictors of AF recurrence following RFCA, with a significant synergistic interaction observed between the two. Their combined assessment may enhance the accuracy of recurrence risk prediction and provide a foundation for the development of individualized intervention strategies.
Keywords: atrial fibrillation (AF), Radiofrequency catheter ablation (RFCA), Recurrence, heart rate variability (HRV), Anxiety
Received: 24 Jun 2025; Accepted: 21 Aug 2025.
Copyright: © 2025 Ren, Zhang and Tian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yufei Ren, Beijing Huilongguan Hospital, Beijing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.