Notably, Grygorowicz et al found that patients who developed incidental AF during follow-up had significantly higher NT-proBNP levels compared to those who remained in sinus rhythm.11 Similarly, Shiroto and Hagii reported that both NT-proBNP and BNP levels were elevated in patients with paroxysmal AF (PAF), with BNP showing a slight advantage in terms of IDI.12 These biomarkers were identified as independent predictors of covert AF, although their moderate diagnostic performance suggests they are better suited as adjunctive tools rather than standalone predictors. This evidence concerns the gene NPPB and Paroxysmal atrial fibrillation.