Blood lipid levels and recurrence of atrial fibrillation after radiofrequency catheter ablation: a prospective study



The relation between dyslipidemia and atrial fibrillation (AF) development remains controversial. We conducted a prospective study to investigate the association of lipids with the risk of recurrence of AF after radiofrequency catheter ablation (RFCA).


This study enrolled 287 consecutive patients who underwent initial circumferential pulmonary vein ablation (CPVA). Fasting levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured at baseline before ablation. Patients were classified according to lipid quartiles. AF recurrence was confirmed by 48-h electrocardiograms at follow-up visits.


A total of 71 patients (24.7%) experienced AF recurrence during 3 to 12 months after ablation. By univariate Cox regression survival analysis, TC (HR, 0.63; 95%CI, 0.48–0.82), LDL-C (HR, 0.61; 95%CI, 0.44–0.84), non-paroxysmal AF type (HR, 2.56; 95%CI, 1.52–4.21), and left atrial diameter (HR, 2.18; 95%CI, 1.46–3.24) were significantly associated with AF recurrence. By multivariate Cox regression survival analysis, lower quartiles of TC (HR, 3.66; 95%CI, 1.56–8.56) and LDL-C (HR, 2.28; 95%CI 1.09–4.77) were associated with higher risk of AF recurrence compared with the highest quartiles. After adjustment by sex, lower TC (HR, 11.70; 95%CI, 2.79–49.13) and LDL-C (HR, 11.00; 95%CI, 2.77–43.72) levels were associated with the recurrence of AF in women, but not in men. HDL-C and TG levels showed no association with AF recurrence in both genders.


TC and LDL-C levels were negatively correlated with AF recurrence after RFCA in women. HDL-C and TG were not independently associated with AF recurrence in both genders.

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We gratefully acknowledge all the participants in our study and we also thank International Science Editing ( for editing this manuscript.


This study was supported by the National Science Foundation for Young Scholars of China (Grant nos. 30900612 and 81800231), the Clinical Research Fund of Zhejiang Provincial Medical Association (2015ZYC-A16 and 2018ZYC-A11), the Grant of Medical Science Research Foundation of Zhejiang Province (Grant no. 2018ZD017), grants from the Zhejiang Provincial Natural Science Foundation (Grant no. LY15H020002 and Y17H020020), and a grant from the Department of Science and Technology, Zhejiang Province (Grant no. LGF19H020011), People’s Republic of China.

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Yunpeng Shang, Nan Chen, and Qiqi Wang conceived the idea for the research, wrote the framework, and drafted the manuscript as the principal author. Chengui Zhuo and Jianqiang Zhao were responsible for the data analysis and revision of the paper and made substantial contributions to the study conception and framework and design. Ning Lv and Yuan Huang performed the statistical analysis and made substantial contributions to the study conception and framework. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Qiqi Wang.

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This study was approved by the Research Ethics Committee of the First Affiliated Hospital of Zhejiang University.

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Shang, Y., Chen, N., Wang, Q. et al. Blood lipid levels and recurrence of atrial fibrillation after radiofrequency catheter ablation: a prospective study. J Interv Card Electrophysiol 57, 221–231 (2020).

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  • Atrial fibrillation recurrence
  • Radiofrequency catheter ablation
  • Cholesterol