Patients with AF undergoing upgrade procedure also show a clinical benefit by decreasing the HF symptoms [NYHA class changes (adjusted OR 0.39; 95% CI 0.18–0.83; P = 0.015) and by decreasing NT-proBNP levels (adjusted difference −1645 pg/mL; 95% CI −3204 to −85; P = 0.039)] (Table 2; Figure 3B). The gene discussed is NPPB; the disease is hydrops fetalis.