Study population

We retrospectively examined the data for 164 consecutive PeAF patients who underwent a first RFCA at the Chinese PLA General Hospital between January 2018 and December 2019. PeAF was defined as an AF episode that lasted more than a week and necessitated medication administration or direct current cardioversion to terminate it. A history of cardiac surgery, moderate to severe mitral regurgitation or stenosis, chronic heart failure (CHF) [New York Heart Association (NYHA) ≥ III class], atrial or ventricular thrombus, current inflammation, hepatopathy, or hyperthyroidism were all excluded from consideration. In addition, all individuals were classified into two groups: those who maintained a stable sinus rhythm throughout follow-up (the “no recurrence group”) and those who had an AF recurrence (recurrence group). All procedures performed in this study involving human participants were in accordance with the Declaration of Helsinki (as revised in 2013). The study was approved by the Human Ethics Review Committee of the Chinese PLA General Hospital and informed consent was taken from all the patients.