The potential value of serum neuron-specific enolase in screening for silent cerebral infarction following radiofrequency catheter ablation for atrial fibrillation

BACKGROUND: Silent cerebral infarction (SCI) is a frequent perioperative complication of catheter ablation for atrial fibrillation (AF), yet its detection currently relies on magnetic resonance imaging (MRI) - a modality not routinely accessible for all patients. This preliminary study investigated whether neuron-specific enolase (NSE), a serum biomarker of neuronal injury, could serve as a practical screening tool for perioperative SCI following radiofrequency ablation for AF. METHODS: ). Multivariate logistic regression, receiver operating characteristic (ROC) curve analysis, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were employed to assess the association between NSE and SCI. RESULTS: significantly improved the model's discriminative performance (NRI = 0.748, 95% CI 0.232-1.064, P < 0.001; IDI = 0.084, 95% CI 0.024-0.114, P = 0.003). CONCLUSION: Serum NSE exhibits high sensitivity for detecting SCI following AF ablation, suggesting its potential as a post-procedural screening tool to help identify patients who may benefit from confirmatory MRI, particularly in resource-constrained settings. Given the exploratory nature of this study and its methodological limitations, these findings should be considered hypothesis-generating and warrant validation in larger, well-designed prospective cohorts.