Circulating MicroRNAs as Molecular Biomarkers of Atrial Fibrillation Recurrence After Catheter Ablation: A Systematic Review and Candidate-Centered Evidence Map
- 1Internal Medicine Department, Faculty of Medicine, Federal University of Goiás, Goiânia 74690-900, Goiás, Brazil
- 2School of Medicine, Pontifical Catholic University of Goiás, Goiânia 74605-010, Goiás, Brazil
- 3Postgraduate Program in Genetics, Pontifical Catholic University of Goiás, Goiânia 74605-010, Goiás, Brazil
Abstract
Background: Recurrence after atrial fibrillation (AF) ablation remains difficult to predict. Circulating microRNAs may reflect molecular substrates not captured by established predictors. We mapped recurrence-specific evidence and identified priorities for prospective validation. Methods: Six databases were searched from inception through 29 August 2026 for adult AF ablation cohorts measuring circulating microRNAs before or around ablation and reporting atrial tachyarrhythmia recurrence. Recurrence-specific reports were assessed with the Quality in Prognosis Studies (QUIPS) tool. A post hoc candidate-centered framework required direct recurrence evidence in at least two analytically distinct samples and support in at least one additional clinical, mechanistic, or analytical domain. Candidate-specific certainty was evaluated with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. Results: Thirty-five publications represented 29 linked programs; 26 recurrence-specific reports represented 25 independent cohorts (3309 enrolled; 3205 analyzed), and nine publications provided longitudinal context. Six microRNAs were identified as priorities for prospective validation: miR-21-5p, miR-150-5p, miR-29b-3p, miR-451a, miR-10b-5p, and miR-320a. Their evidence differed in mature-arm identity, matrix, sampling compartment, assay scale, biological source, and mechanistic support. Candidate-specific certainty was very low. Conclusions: The evidence supports candidate-specific prospective validation rather than a uniform circulating-microRNA class effect. Standardized preanalytics, mature-arm and carrier attribution, locked assays, and multicenter incremental-prediction studies are required before clinical utility can be established.
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BibTeX
@article{menezes2026circulating,
title = {{Circulating MicroRNAs as Molecular Biomarkers of Atrial Fibrillation Recurrence After Catheter Ablation: A Systematic Review and Candidate-Centered Evidence Map}},
author = {Antônio da Silva Menezes and Arthur de Sousa Silva and Alcir Júnior de Paula Nunes Meneses and Annelyse Vitória Souza Barbosa and Aparecido Divino da Cruz},
journal = {Biomolecules},
year = {2026},
month = nov,
doi = {10.3390/biom16111590},
url = {https://www.mdpi.com/2218-273X/16/11/1590},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Circulating MicroRNAs as Molecular Biomarkers of Atrial Fibrillation Recurrence After Catheter Ablation: A Systematic Review and Candidate-Centered Evidence Map
AU - Antônio da Silva Menezes
AU - Arthur de Sousa Silva
AU - Alcir Júnior de Paula Nunes Meneses
AU - Annelyse Vitória Souza Barbosa
AU - Aparecido Divino da Cruz
PY - 2026
DA - 2026/11/02
JO - Biomolecules
DO - 10.3390/biom16111590
UR - https://www.mdpi.com/2218-273X/16/11/1590
AB - Background: Recurrence after atrial fibrillation (AF) ablation remains difficult to predict. Circulating microRNAs may reflect molecular substrates not captured by established predictors. We mapped recurrence-specific evidence and identified priorities for prospective validation. Methods: Six databases were searched from inception through 29 August 2026 for adult AF ablation cohorts measuring circulating microRNAs before or around ablation and reporting atrial tachyarrhythmia recurrence. Recurrence-specific reports were assessed with the Quality in Prognosis Studies (QUIPS) tool. A post hoc candidate-centered framework required direct recurrence evidence in at least two analytically distinct samples and support in at least one additional clinical, mechanistic, or analytical domain. Candidate-specific certainty was evaluated with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. Results: Thirty-five publications represented 29 linked programs; 26 recurrence-specific reports represented 25 independent cohorts (3309 enrolled; 3205 analyzed), and nine publications provided longitudinal context. Six microRNAs were identified as priorities for prospective validation: miR-21-5p, miR-150-5p, miR-29b-3p, miR-451a, miR-10b-5p, and miR-320a. Their evidence differed in mature-arm identity, matrix, sampling compartment, assay scale, biological source, and mechanistic support. Candidate-specific certainty was very low. Conclusions: The evidence supports candidate-specific prospective validation rather than a uniform circulating-microRNA class effect. Standardized preanalytics, mature-arm and carrier attribution, locked assays, and multicenter incremental-prediction studies are required before clinical utility can be established.
SN - 2218-273X
ER -