A retrospective cohort and machine learning study on the efficacy, safety, and recurrence prediction of combined EI-VOM and linear ablation in persistent Non-valvular atrial fibrillation

CPVI + PLUS significantly improved arrhythmia-free survival, cardiac function, and quality of life in patients with PeNVAF without increasing procedural risk. Multivariate and machine learning analyses confirmed that additional ablation and left atrial appendage occlusion were protective against recurrence, while heart failure, valvular regurgitation, and longer AF course increased risk. The stacking model showed excellent predictive performance, and key features identified may support precise risk stratification and individualized therapy.