Background The purpose of this study was to evaluate the predictive values of lipid level, inflammatory biomarkers, and echocardiographic parameters in late NVAF (nonvalvular atrial fibrillation) recurrence after RFA (radiofrequency ablation). Material/Methods This retrospective single-center study enrolled 263 patients with paroxysmal or persistent NVAF who underwent initial RFA from Jan 2017 to Jan 2019. The patients were divided into a Recurrent group (n=70) and a Nonrecurrent group (n=193). Univariate and multivariate logistic regression analyses were used for evaluating the predictive factors of late NVAF recurrence. Receiver operating characteristic (ROC) curves were constructed to assess the predictive performance and the optimum cut-off level of variables. Results Late NVAF recurrence occurred in 70 patients (26.6%) after initial RFA within 12-month follow-up. Patients in the Recurrent group had significant higher NLR (neutrophil-to-lymphocyte ratio), hs-CRP (high-sensitivity C-reactive protein), LVEDD (left ventricular end-diastolic dimension), LVESD (left ventricular end-systolic dimension), and LAD (left atrial diameter) than those in the Nonrecurrent group ( P <0.05). In multivariate analysis, increased NLR (HR=1.438, 95% CI: 1.036–1.995, P <0.05), hs-CRP (HR=1.137, 95% CI: 1.029–1.257, P <0.05) and LAD (HR=1.089, 95% CI: 1.036–1.146, P <0.05) were independent predictors of NVAF recurrence. The area under the curve (AUC) of NLR and hs-CRP was 0.603 (95% CI 0.525–0.681) and 0.584 (95% CI 0.501–0.666), respectively. The combination of NLR, hs-CRP, and LAD revealed an AUC of 0.684 (95% CI 0.611–0.757), with cut-off values of 2.33, 2.025 ng/L, and 44.5 mm, respectively. Conclusions The combination of preoperative NLR, hs-CRP, and LAD can predict late NVAF recurrence.

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BackgroundThere is currently no classification for acute myocardial infarction (AMI) according to left ventricular ejection fraction (LVEF). We aimed to perform a retrospective analysis of patients undergoing emergency percutaneous coronary intervention (PCI), comparing the clinical characteristics, in-hospital acute heart failure and all-cause death events of AMI patients with mid-range ejection fraction (mrEF), preserved ejection fraction (pEF) and reduced ejection fraction (rEF).Material and methodsTotally 1270 patients were stratified according to their LVEF immediately after emergency PCI into pEF group (LVEF 50% or higher), mrEF group (LVEF 40%–49%) and rEF group (LVEF <40%). Kaplan-Meier curves and log rank tests were used to assess the effects of mrEF, rEF and pEF on the occurrence of acute heart failure and all-cause death during hospitalisation. The Cox proportional hazards model was used for multivariate correction.ResultsCompared with mrEF, rEF was an independent risk factor for acute heart failure events during hospitalisation (HR 5.01, 95% CI 3.53 to 7.11, p<0.001), and it was also an independent risk factor for all-cause mortality during hospitalisation (HR 7.05, 95% CI 4.12 to 12.1, p<0.001); Compared with mrEF, pEF was an independent protective factor for acute heart failure during hospitalisation (HR 0.49, 95% CI 0.30 to 0.82, p=0.01), and it was also an independent protective factor for all-cause death during hospitalisation (HR 0.33, 95% CI 0.11 to 0.96, p=0.04).ConclusionsmrEF patients with AMI undergoing emergency PCI share many similarities with pEF patients in terms of clinical features, but the prognosis is significantly worse than that of pEF patients, suggesting that we need to pay attention to the management of mrEF patients with AMI.

Objective Radiofrequency catheter ablation (RFCA) is a standard treatment for idiopathic premature ventricular complexes (PVCs). This study was aimed to determine autonomic nervous system (ANS) activity in patients with low, medium and high PVC burdens pre- and pro-RFCA. Methods We retrospectively analyzed a total of 200 patients underwent radiofrequency ablation surgery for idiopathic PVCS from June 2017 to March 2021. The procedural ablation success was achieved in 179 of the 200 (89.5%). Patients had success ablation was classified into low burden PVC group (PVCs/min ≤15%), medium burden PVC group (15%> PVCs/min <25%) and high burden PVC group (PVCs/min ≥25%). We assessed the clinical data, time and frequency-domain variables, heart rate turbulence(HRV) and deceleration capacity of rate of patients with different PVC burdens and various ablation site. Spearman correlation analysis was performed.Results High burden PVCs had higher mean HR, SDANN, SDNN index, standard deviation of normal to normal intervals (SDNN), root-mean square successive differences (rMSSD), pNN50 and lower ratio of low-frequency (LF)/ high-frequency (HF), compared to low burden PVCs. After ablation, SDNN, SDNN index, SDANN, rMSSD, pNN50, TS (turbulence slope) and DC (deceleration capacity) were significantly decreased (P<0.01), while LF/HF and TO was significantly increased (P<0.01). The burden of preoperative PVCs was positively correlated with LVD, mean HR, SDNN index, SDANN, rMSSD and pNN50, but negatively correlated with TC, LDL-C, LVEF and LF/HF. Regression analysis showed that the burden of PVCs was positively correlated with mean HR (P=0.000), SDANN (P=0.000) and rMSSD (P=0.000).Conclusion With the increase of PVCS burden, both sympathetic and vagus nerve activities are enhanced. The numbers of PVCS may be related to impaired autonomic nerve balance regulation. RFCA reduced parasympathetic activity and sympathetic activity after eradication of PVCS.