Mindfulness-based perioperative care, sleep architecture, autonomic regulation, and early atrial tachyarrhythmia recurrence after radiofrequency catheter ablation for atrial fibrillation: a prospective observational cohort study.

This study aimed to examine the relationship between perioperative care by mindfulness and sleep quality, autonomic regulation, inflammatory activity, and early recurrence of atrial tachyarrhythmia (AT) following radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). This was a prospective assessor-blinded observational cohort study involving 124 patients with AF who underwent their initial radiofrequency catheter ablation from April 2023 to December 2025. Conventional perioperative care was provided to one group (n=62), while the other group (n=62) received mindfulness-based perioperative care. To reduce baseline imbalance, propensity score overlap weighting was implemented. Objective sleep architecture was assessed by overnight polysomnography and autonomic function was examined by HRV analysis. hs-CRP, IL-6, TNF-α, IL-1β, and MCP-1 were analyzed by enzyme-linked immunosorbent assays. Health related quality of life was determined based on the SF-36 questionnaire. Compared with conventional care, mindfulness-based perioperative care was associated with greater observed changes in total sleep time (389.4 ± 43.8 vs. 365.7 ± 45.2 min, P=0.012), sleep efficiency (77.4 ± 7.2% vs. 71.2 ± 7.8%, P=0.004), sleep onset latency (27.1 ± 8.8 vs. 34.8 ± 10.5 min, P=0.009), and PSQI scores (7.2 ± 2.5 vs. 9.3 ± 2.9, P=0.006). The mindfulness group also showed lower inflammatory biomarker levels and differences in short-term autonomic indices, including a lower LF/HF ratio (1.39 ± 0.41 vs. 1.66 ± 0.54, P=0.005). Early atrial tachyarrhythmia recurrence occurred in 6 patients (9.7%) in the mindfulness-based perioperative care group and in 11 patients (17.7%) in the conventional care group, corresponding to a crude risk ratio of 0.55 (95% CI: 0.22-1.38). Mindfulness-based perioperative care was associated with improved objective and subjective sleep quality, more favorable autonomic and inflammatory biomarker profiles, better postoperative quality of life, and a lower observed rate of early atrial tachyarrhythmia recurrence after radiofrequency catheter ablation for AF.