Objective To investigate the predictive value of serum macrophage inflammatory protein-1α( MIP-1α) ， fibroblast growth factor-23 ( FGF-23) ，and histone deacetylase 3 ( HDAC3) for recurrence in patients with paroxysmal atrial fibrillation ( PAF) after radiofrequency ablation ( ＲFA) ． Methods A total of 245 PAF patients who received ＲFA treatment in Emergency General Hospital from June 2021 to June 2023 were included as the study group． They were assigned into a recurrence group ( 64 cases) and a non-recurrence group ( 181 cases) based on their recurrence status 12 months after ＲFA． A total of 245 healthy subjects were selected as the control group． Enzyme linked immunosorbent assay ( ELISA) was applied to detect the levels of serum MIP-1α，FGF-23，and HDAC3． Pearson correlation was applied to analyze the correlation between · 862 · 疑难病杂志 2025 年 3 月第 24 卷第 3 期 Chin J Diffic and Compl Cas，March 2025，Vol． 24，No． 3serum MIP-1α，FGF-23，HDAC3 levels and left atrial anterior posterior diameter ( LAD) ，left atrial volume index ( LAVI) ， and left ventricular ejection fraction ( LVEF) in patients with PAF． Multi-factor Logistic regression model was applied to analyze the factors affecting the recurrence of ＲFA in PAF patients． ＲOC curve was applied to evaluate the predictive value of MIP-1α，FGF-23，and HDAC3 for recurrence in PAF patients after ＲFA． Ｒesults The levels of serum MIP-1α，FGF-23， HDAC3，LAD，and LAVI in the study group were higher than those in the control group，while the LVEF in the study group was lower than that in the control group ( t = 88． 773，83． 283，55． 911，36． 510，31． 806，37． 894，all P ＜ 0． 001) ． According to Pearson correlation analysis，serum MIP-1α，FGF-23，and HDAC3 in PAF patients were positively correlated with LAD and LAVI ，and negatively correlated with LVEF( MIP-1α: r/P = 0． 534 / ＜ 0． 001、0． 621 / ＜ 0． 001、－ 0． 582 / ＜ 0． 001; FGF- 23: r/P = 0． 479 / ＜ 0． 001、0． 637 / ＜ 0． 001、－ 0． 609 / ＜ 0． 001; HDAC3: r/P = 0． 515 / ＜ 0． 001、0． 674 / ＜ 0． 001、－ 0． 715 / ＜ 0． 001) ． The proportion of patients aged ≥60 years，the proportion of patients with concomitant coronary heart disease ( CHD) ，the levels of serum MIP-1α，FGF-23，HDAC3，and the LAD and LAVI in the recurrence group were higher than those in the non-recurrence group，the duration of PAF in the recurrence group was longer than that in the non-recurrence group，the LVEF in the recurrence group was lower than that in the non-recurrence group ( t / χ 2 = 12． 861，11． 022，32． 826， 5． 286，7． 312，9． 581，28． 965，29． 296，25． 505，all P ＜ 0． 001) ． Multivariate Logistic regression analysis showed that MIP-1α，FGF-23，HDAC3，and CHD were risk factors for recurrence in PAF patients after ＲFA［OＲ( 95% CI) = 2． 684( 1． 376 － 5． 237) ，2． 349( 1． 419 － 3． 887) ，3． 124 ( 1． 407 － 6． 937) ，3． 017 ( 1． 312 － 6． 940) ］． The AUC value of serum MIP-1α，FGF-23，and HDAC3 and their combination for predicting recurrence in PAF patients after ＲFA was 0． 747，0． 777， 0． 769，and 0． 912，respectively． The AUC value of the combined detection of the three was higher than that of the independent detection of MIP-1α，FGF-23 and HDAC3 ( Z = 3． 940，3． 356，3． 414，all P ＜ 0． 001) ． Conclusion The levels of serum MIP-1α，FGF-23，and HDAC3 are all elevated in PAF patients who experience recurrence after ＲFA． The combined detection of the three can improve the predictive value for recurrence in PAF patients after ＲFA． 【Key words】 Paroxysmal atrial fibrillation; Ｒadiofrequency ablation; Macrophage inflammatory protein-1α; Fibroblast growth factor-23; Histone deacetylase 3; Prognostic value