The risk of malnutrition as a predictor of arrhythmia recurrence after catheter ablation in patients with paroxysmal non-valvular atrial Fibrillation and heart failure with preserved ejection fraction.

<h4>Background</h4>Malnutrition presents a significant challenge in managing patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF), yet its impact on AF recurrence after catheter ablation in this population remains unclear.<h4>Methods<...

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Main Authors: Zixi Zhang, Cancan Wang, Qiming Liu, Yichao Xiao, Jiabao Zhou, Keke Wu, Yunying Huang, Zeying Zhang, Shiping Liu, Qiuzhen Lin
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0317721
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author Zixi Zhang
Cancan Wang
Qiming Liu
Yichao Xiao
Jiabao Zhou
Keke Wu
Yunying Huang
Zeying Zhang
Shiping Liu
Qiuzhen Lin
author_facet Zixi Zhang
Cancan Wang
Qiming Liu
Yichao Xiao
Jiabao Zhou
Keke Wu
Yunying Huang
Zeying Zhang
Shiping Liu
Qiuzhen Lin
author_sort Zixi Zhang
collection DOAJ
description <h4>Background</h4>Malnutrition presents a significant challenge in managing patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF), yet its impact on AF recurrence after catheter ablation in this population remains unclear.<h4>Methods</h4>We conducted a retrospective analysis of 204 patients with paroxysmal non-valvular AF and HFpEF who underwent radiofrequency or cryoballoon ablation. Risk of malnutrition as assessed using three screening tools: the Controlling Nutritional Status (CONUT) score, Prognostic Nutritional Index (PNI), and Nutritional Risk Index (NRI)]. We examined the relationship between risk of malnutrition and AF recurrence post-ablation.<h4>Results</h4>After a mean follow-up period of 11.2 ±  1.8 months, 43 patients (21.1%) experienced AF recurrence. Despite being classified as overweight or obese based on body mass index, many patients were at risk of malnutrition according to the CONUT score, NRI, and PNI. Adjusted analyses showed that higher CONUT scores (HR: 10.132; 95% CI: 2.545-40.336; P =  0.001), lower NRI (HR: 22.734; 95% CI: 6.399-80.776; P <  0.001), or lower PNI (HR: 9.469; 95% CI: 3.232-27.739; P <  0.001) were significantly associated with increased risk of AF recurrence. Restricted cubic spline regression revealed an inverted U-shaped relationship between the CONUT score and AF recurrence, and L-shaped relationships for both NRI and PNI with AF recurrence.<h4>Conclusions</h4>Systematic nutritional assessment is crucial in patients with paroxysmal non-valvular AF and HFpEF. High CONUT scores, low NRI, or low PNI serve as independent predictors for AF recurrence. Further large-scale randomized controlled trials are required to validate these findings.
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spelling doaj-art-a0f8a9ff072f406582938cceec7e04642025-02-05T05:31:37ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01201e031772110.1371/journal.pone.0317721The risk of malnutrition as a predictor of arrhythmia recurrence after catheter ablation in patients with paroxysmal non-valvular atrial Fibrillation and heart failure with preserved ejection fraction.Zixi ZhangCancan WangQiming LiuYichao XiaoJiabao ZhouKeke WuYunying HuangZeying ZhangShiping LiuQiuzhen Lin<h4>Background</h4>Malnutrition presents a significant challenge in managing patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF), yet its impact on AF recurrence after catheter ablation in this population remains unclear.<h4>Methods</h4>We conducted a retrospective analysis of 204 patients with paroxysmal non-valvular AF and HFpEF who underwent radiofrequency or cryoballoon ablation. Risk of malnutrition as assessed using three screening tools: the Controlling Nutritional Status (CONUT) score, Prognostic Nutritional Index (PNI), and Nutritional Risk Index (NRI)]. We examined the relationship between risk of malnutrition and AF recurrence post-ablation.<h4>Results</h4>After a mean follow-up period of 11.2 ±  1.8 months, 43 patients (21.1%) experienced AF recurrence. Despite being classified as overweight or obese based on body mass index, many patients were at risk of malnutrition according to the CONUT score, NRI, and PNI. Adjusted analyses showed that higher CONUT scores (HR: 10.132; 95% CI: 2.545-40.336; P =  0.001), lower NRI (HR: 22.734; 95% CI: 6.399-80.776; P <  0.001), or lower PNI (HR: 9.469; 95% CI: 3.232-27.739; P <  0.001) were significantly associated with increased risk of AF recurrence. Restricted cubic spline regression revealed an inverted U-shaped relationship between the CONUT score and AF recurrence, and L-shaped relationships for both NRI and PNI with AF recurrence.<h4>Conclusions</h4>Systematic nutritional assessment is crucial in patients with paroxysmal non-valvular AF and HFpEF. High CONUT scores, low NRI, or low PNI serve as independent predictors for AF recurrence. Further large-scale randomized controlled trials are required to validate these findings.https://doi.org/10.1371/journal.pone.0317721
spellingShingle Zixi Zhang
Cancan Wang
Qiming Liu
Yichao Xiao
Jiabao Zhou
Keke Wu
Yunying Huang
Zeying Zhang
Shiping Liu
Qiuzhen Lin
The risk of malnutrition as a predictor of arrhythmia recurrence after catheter ablation in patients with paroxysmal non-valvular atrial Fibrillation and heart failure with preserved ejection fraction.
PLoS ONE
title The risk of malnutrition as a predictor of arrhythmia recurrence after catheter ablation in patients with paroxysmal non-valvular atrial Fibrillation and heart failure with preserved ejection fraction.
title_full The risk of malnutrition as a predictor of arrhythmia recurrence after catheter ablation in patients with paroxysmal non-valvular atrial Fibrillation and heart failure with preserved ejection fraction.
title_fullStr The risk of malnutrition as a predictor of arrhythmia recurrence after catheter ablation in patients with paroxysmal non-valvular atrial Fibrillation and heart failure with preserved ejection fraction.
title_full_unstemmed The risk of malnutrition as a predictor of arrhythmia recurrence after catheter ablation in patients with paroxysmal non-valvular atrial Fibrillation and heart failure with preserved ejection fraction.
title_short The risk of malnutrition as a predictor of arrhythmia recurrence after catheter ablation in patients with paroxysmal non-valvular atrial Fibrillation and heart failure with preserved ejection fraction.
title_sort risk of malnutrition as a predictor of arrhythmia recurrence after catheter ablation in patients with paroxysmal non valvular atrial fibrillation and heart failure with preserved ejection fraction
url https://doi.org/10.1371/journal.pone.0317721
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