Recurrence rate after radiofrequency catheter ablation (RFCA) remains high, and further investigation on predictors of recurrence is needed.

To identify risk factors of atrial fibrillation (AF) recurrence in patients undergoing RFCA.

We retrospectively studied 257 patients with AF who underwent RFCA preceded by transthoracic echocardiographic and pulmonary vein CT examination from 2016 to 2019. Electrocardiogram examination was performed at baseline, 1, 3, 6 months, and 1 year after RFCA. We divided patients into two groups based on AF recurrence including recurrence group (n = 79) and nonrecurrence group (n = 178). The crude and independent association between clinical variables and AF recurrence was evaluated with logistic regression analysis. Specificity and positive predictive value of relevant factors for AF recurrence were performed by ROC curve.

Of these AF patients, 174 (68%) was paroxysmal AF and 83 (32%) was persistent AF. The multivariate logistic regression demonstrated that AF duration (OR = 1.008, 95% CI 1.002–1.013, p = .008), pulmonary arterial hypertension (PAH; OR = 2.313, 95% CI 1.031–5.192, p = .042), and low‐density lipoprotein cholesterol (LDL‐C; OR = 1.646, 95% CI 1.129–2.398, p = .010) were independently correlated with recurrence of AF. For predicting AF recurrence, the specificity and sensitivity of AF duration were 30.1% and 87.3%, and for LDL‐C, the specificity and sensitivity of AF duration were 60.6% and 60.5%, respectively.

Atrial fibrillation duration, PAH, and LDL‐C might be independent risk factors for the recurrence of AF after RFCA.