Effect Of Smoking Index On The Risk Of Atrial Fibrillation Recurrence After Catheter Ablation

Objectives:The effect of smoking on atrial fibrillation recurrence after catheter ablation remains unclear,particularly in terms of smoking index,given that outcomes vary with smoking levels.Therefore,this study aimed to assess the relationship between the smoking index and risk of atrial fibrillation recurrence in patients who underwent catheter ablation.Methods:This retrospective study included patients who underwent catheter ablation for atrial fibrillation between January 2016 and December 2020.The relationship between different smoking indices and atrial fibrillation recurrence after catheter ablation was analyzed.All patients had persistent or paroxysmal atrial fibrillation,as confirmed by clinical symptoms and ambulatory electrocardiographic findings.Results:After a mean follow-up period of 17±7 months,the atrial fibrillation recurrence rate was higher in the smoking population after catheter ablation than in the non-smoking population(29.6%vs.21.1%,P<0.05).Smoking was observed to produce a greater risk(hazard ratio=1.653,[95%confidence interval {CI}:1.226-2.230];P<0.01).The risk of atrial fibrillation recurrence increased as the smoking index increased,particularly in the group with the highest smoking index(hazard ratio=2.388,[95%CI:1.618-3.525];P<0.01).Former smokers were more likely to relapse than never smokers(41.7%vs.21.1%,hazard ratio=1.670,[95%CI:1.227-2.271];P<0.01).COX multivariate regression analysis showed that left ventricular ejection fraction,NT-proBNP level,and smoking were independent risk factors for AF recurrence.Conclusions:Smoking is significantly associated with overall recurrence in patients undergoing catheter ablation for AF.As the smoking index increased,the recurrence rate and hazard ratio of AF also increased.This suggests that smoking has an adverse effect on the success of catheter ablation for AF.