Statistical analysis
Continuous variables with normal distribution were described as the mean+ SD for normally distributed data, and comparisons between
groups were performed with Student t test. Nonnormally distributed
continuous data were summarized as median (interquartile range) and
compared with the Mann-Whitney test. Categorical variables were
described as counts and compared by chi-square test. Survival curves
were generated with the Kaplan–Meier analysis and compared by log rank
test. Cox regression analysis was used to determine the independent
predictors for the primary endpoint, with a determination of hazard
ratio (HR) and 95% confidence interval (CI) for each variable in the
model. Variables selected for testing in the multivariate analysis were
those with P < 0.05 in the univariate model.
Moreover, 1:1 PSM was performed as sensitivity analysis. PSM was
performed between medical treatment group and catheter ablation group.
We used a multivariable logistic regression model to estimate propensity
scores, with catheter ablation as the dependent variable and the
following factors as covariates: age, sex, body mass index, AF type,
NYHA class, laboratory findings including NT-ProBNP, estimated
glomerular filtration rate, serum ureic acid level, past medical history
including hypertension, diabetes mellitus, coronary heart disease,
stroke, medication including diuretics, beta-blocker, angiotensin
converting enzyme inhibitor/angiotensin II receptor
antagonist/angiotensin receptor neprilysin inhibitor, mineralocorticoid
antagonist, anticoagulant, antiplatelet agent, and transthoracic
echocardiography (TTE) parameters including LAD, LVEDD, and LVEF. PSM
was performed with the nearest neighbor matching algorithm and a 1:1
ratio. Because decreased sample size in PSM might weaken the statistical
power and not all covariates were well balanced, we further performed
propensity score weighting by IPTW method with the same covariates in
PSM.
All tests were 2-tailed, and a statistical significance was established
at P < 0.05. All analyses were performed using R 4.0.4 and
SPSS software (version 22.0; SPSS, Inc., Chicago)