Consistency between recurrent risk perception and objective recurrence risk in patients after atrial fibrillation ablation: a cross-sectional study

OBJECTIVE: This study aimed to evaluate the consistency between the patients' recurrent risk perception and APPLE-estimated recurrence risk after atrial fibrillation (AF) ablation and to investigate the factors possibly contributing to the inconsistency between them. METHODS: This study included 210 hospitalized patients who underwent AF ablation in the cardiology departments of two tertiary care hospitals in Qingdao. We utilized a single question to measure AF recurrence risk perception of the participants; and the APPLE score served as a robust metric for assessing their APPLE-estimated recurrence risk. The accuracy of AF recurrence risk perception was calculated via comparing recurrence risk perception against APPLE-estimated recurrence risk and was then classified into three categories: "underestimated", "accurate," and "overestimated". Additionally, logistic regression analysis was employed to examine the factors that may contribute to patients' inaccurate perception of their recurrence risk. RESULTS: Our consistency analysis showed that 38.31% of patients underestimated their AF recurrence risk, while 28.72% overestimated it. Multinomial logistic regression analyses demonstrated that individuals with lower social support (OR = 0.519; 95% CI: 0.393-0.686; p < 0.001) and an indifferent attitude towards AF recurrence (OR = 0.028; 95%CI: 0.005-0.152; p < 0.001) were more likely to underestimate their risk. In contrast, those with increased levels of anxiety (OR = 2.065; 95%CI: 1.423-2.996; p < 0.001), diminished ability to perform activities of daily living(OR = 12.614; 95%CI: 3.146-50.574; p < 0.001), and worry about recurrent AF(OR = 7.978; 95%CI: 1.306-48.742; p = 0.025)demonstrated a greater tendency to overestimate their risk. CONCLUSIONS: This study showed that many participants after AF ablation had inaccurate perceptions of their AF recurrence risk. Among them, those who underestimated the risk accounted for a large proportion, factors associated with low social support and an indifferent attitude towards AF recurrence.