Zhihao Zhao,1,2 Xiaoqin Hu,1 Chaoqun Zhang,1 Chengzong Li,1 Fengyun Zhang,1 Yu Yang1 

1Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People’s Republic of China; 2Department of Cardiology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou First People’s Hospital, Xuzhou, People’s Republic of China

Correspondence: Fengyun Zhang, Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People’s Republic of China, Email zhangfengyun0605@126.com Yu Yang, Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People’s Republic of China, Email xuzhouyangyu@163.com

Purpose: To investigate the relationship between phenotypic age (PhenoAge) and accelerated phenotypic age (PhenoAgeAccel) and recurrence of atrial fibrillation (AF) in patients after radiofrequency catheter ablation (RFCA).
Patients and Methods: Preoperative PhenoAge and PhenoAgeAccel were determined in AF patients undergoing RFCA. We used logistic regression models and subgroup analysis to study the relationship between PhenoAge and PhenoAgeAccel and the risk of AF recurrence. As for revealing the value of PhenoAgeAccel in predicting AF recurrence, the ROC curve analysis was performed. To further detect the enhancement role of in PhenoAgeAccel in the APPLE score and a model of established risk factors in predicting AF recurrence, C‐statistics, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) was conducted.
Results: A total of 322 patients with AF who underwent RFCA in our hospital were included in the present study. The mean follow-up period was 21 months. The frequency of AF recurrence increased gradually as the PhenoAgeAccel index rose. The optimal cut-off value of the PhenoAgeAccel index was − 0.338. Patients with PhenoAgeAccel ≥ -0.338 had a significantly greater likelihood of experiencing recurrent AF than those with PhenoAgeAccel <-0.338 (OR 3.989, 95% CI 2.006– 7.933, p <  0.001). The association was also reflected in each subgroup. Incorporating the PhenoAgeAccel into the APPLE score and the existing model of established risk factors for recurrence may result in enhancements to the C-statistics, NRI and IDI (p< 0.05), respectively.
Conclusion: PhenoAgeAccel was positively and independently associated with AF recurrence following RFCA.

Keywords: atrial fibrillation, radiofrequency catheter ablation, recurrence, phenotypic age, accelerated phenotypic age