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<p>Abstract</p> <p>Background</p> <p>Increasing evidences have suggested that autoantibodies against muscarinic-2 acetylcholine receptor (anti-M₂-R) may play an important role in the development of atrial fibrillation (AF). Predictive value of pre-procedural anti-M₂-R for the recurrence of AF after radiofrequency catheter ablation is still unclear.</p> <p>Methods</p> <p>Totally 76 AF patients with preserved left ventricular systolic function were prospectively enrolled and subjected to ablation after the detection of serum anti-M₂-R by enzyme linked immunosorbent assay. These patients were given follow-up examination for one year after ablation. Risk estimation for the recurrence of AF was performed using the univariate and multivariate logistic regression.</p> <p>Results</p> <p>In AF group, serum anti-M₂-R was significantly higher than that in the control group in terms of frequency (40.8% versus 11.7%; <it>p</it> < 0.001) and titer (1:116 versus 1:29; <it>p</it> < 0.001). Compared with paroxysmal AF patients, persistent AF patients had higher frequency (57.6% versus 27.9%; <it>p</it> = 0.009) and titer (1:132 versus 1:94; <it>p</it> = 0.012) for autoantibodies. During one-year follow-up examination after ablation, the recurrence of AF was observed in 25 (32.9%) patients. Multivariate analysis showed that pre-procedural serum anti-M₂-R was an independent predictor for the recurrence of AF at the time point of 12 months after ablation (odds ratio: 4.701; 95% confidence interval: 1.590-13.894; <it>p</it> = 0.005).</p> <p>Conclusions</p> <p>In AF patients, the frequency and titer of serum anti-M₂-R were significantly higher than those in the control group with sinus rhythm. Pre-procedural serum anti-M₂-R was an independent predictor for the recurrence of AF one year after radiofrequency catheter ablation.</p>