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)