Subsequently, VEN was titrated up to 375 mg/day, and by 11 December 2023, the patient experienced recurrent heart failure, evidenced by a decline in LVEF to 42% and NT-proBNP elevation to 3464 ng/L, though, notably, paroxysmal atrial fibrillation was absent. This evidence concerns the gene NPPB and Paroxysmal atrial fibrillation.