The Effect of Vericiguat on Recurrence after Catheter Ablation of Atrial Fibrillation

Objectives: Atrial fibrillation (AF) is one of the most common arrhythmias in China. For patients with symptomatic paroxysmal atrial fibrillation, catheter ablation has become a first-line treatment option. This study aims to investigate whether oral vericiguat treatment can reduce the recurrence of atrial fibrillation/atrial tachycardia (AF/AT) following catheter ablation for atrial fibrillation. Methods: According to the patients’ wishes, a total of 39 patients were divided into two groups: a control group and a group receiving oral vericiguat treatment. Both groups received guideline-directed medical therapy for atrial fibrillation. Follow-up was arranged at 1-3 months, 6 months and 12 months after the operation. The primary endpoint was the occurrence of atrial tachyarrhythmias after a 3-month blanking period. Secondary endpoints included left ventricular ejection fraction (LVEF), left atrial anterior-posterior diameter (LAAPD), right ventricular diameter, right ventricular outflow tract, aortic root, ascending aortic diameter, interventricular septal thickness, left ventricular posterior wall thickness, left ventricular end-diastolic diameter (LVEDD), and pulmonary artery diameter. Results: At 12 months post-procedure, vericiguat reduced the recurrence rate of AF/AT and decreased the LAAPD and LVEDD. However, vericiguat did not reduce the recurrence rate of AF/AT during the blanking period or at 6 months post-procedure, and no improvement in LVEF was observed. Conclusion: Vericiguat may reduce the long-term recurrence rate of atrial fibrillation after catheter ablation by inhibiting atrial and ventricular remodeling. These findings provide experimental evidence for the potential application of vericiguat in the management of patients following atrial fibrillation ablation.