Development and validation of a nomogram model based on inflammatory markers and cardiac parameters: predicting the risk of recurrence in patients with atrial fibrillation after radiofrequency catheter ablation

This study aimed to identify independent predictors of recurrence after catheter ablation for atrial fibrillation (AF) and develop a nomogram for individualized risk assessment. Data from 516 AF patients undergoing first-time radiofrequency ablation between July 2020 and May 2025 were retrospectively analyzed. Univariate and multivariate Cox regression identified independent risk factors, with restricted cubic spline (RCS) analyzing dose-response relationships for continuous variables. Patients were divided into training and validation sets (7:3 ratio) via stratified random sampling. The nomogram was evaluated using the C-statistic, calibration plots, and decision curve analysis (DCA) for discrimination, calibration, and clinical utility. The nomogram incorporated left atrial diameter (LAD), left ventricular ejection fraction (LVEF), type of AF, D-dimer (DD), and neutrophil-to-lymphocyte ratio (NLR). It demonstrated a C-index of 0.731. Calibration curves indicated strong agreement between predicted and observed outcomes, and DCA confirmed clinical net benefit within a 10%–50% threshold probability range. The nomogram provides accurate, individualized prediction of one-year post-ablation AF recurrence risk, facilitating early identification of high-risk patients and offering valuable prognostic insight.