Key predictive features included NT-proBNP and texture heterogeneity features from EAT, which align with known pathophysiological mechanisms involving systemic inflammation, metabolic dysregulation, and local atrial adipose tissue remodeling.<h4>Conclusion</h4>A fusion model incorporating EAT radiomics and clinical variables effectively predicts AF recurrence after PVI, with ensemble methods showing optimal performance. The gene discussed is NPPB; the disease is atrial fibrillation.