Atrial fibrillation type modulates the clinical predictive value of neutrophil-to-lymphocyte ratio for atrial fibrillation recurrence after catheter ablation

Abstract

Background The neutrophil-to-lymphocyte ratio (NLR) has been proposed as an indicator of a systemic inflammatory response. There are baseline differences in the inflammation status between paroxysmal atrial fibrillation (PAF) and persistent AF (PerAF). The NLR changes and late recurrences of AF (LRAF) after ablation depending on the AF type remain unknown. Methods Consecutive AF patients undergoing pulmonary vein isolation (PVI) by radiofrequency catheter ablation were enrolled from September 2014 to June 2018. The peripheral blood leukocyte NLR 1 day before and 36–48 h after PVI were measured. First, the relationship between NLR changes after to before ablation (ΔNLR) and ERAFs/LRAFs in PAF and PerAF patients were investigated to exclude the baseline inflammation status and evaluate catheter ablation induced inflammation. Second, the clinical impact of the NLR for predicting LRAFs was evaluated. Results There hundred sixty-nine PAF and 264 PerAF patients from Osaka Rosai AF registry were enrolled. The ratio of ERAFs/LRAFs in PAF and PerAF patients were 26.8%/22.5% and 39.4%/29.9%, respectively. In PAF and PerAF patients, the ΔNLR was significantly higher with ERAF than no-ERAF (p = 0.022 and p = 0.010, respectively). In PAF patients, the ΔNLR was significantly higher with LRAF than no-LRAF (p = 0.017), while with PerAF, the ΔNLR did not significantly differ between LRAFs and no-LRAFs. In PAF, the ΔNLR was independently and significantly associated with LRAFs after PVI (p = 0.029). Conclusion The ΔNLR was significantly higher only in PAF patients with LRAFs than no-LRAFs, but not in PerAF patients. The ΔNLR was useful for predicting LRAFs after PVI in PAF patients.

Association between the systemic immune‐inflammation index and outcomes among atrial fibrillation patients with diabetes undergoing radiofrequency catheter ablation

“…Lymphocytes play an essential role in the regulation of the immune systems 33 and inflammation enhances the apoptosis of lymphocytes 34 . NLR has been shown to be significantly associated with the development and recurrence of AF 35 . In our study, SII was superior to NLR as a prognostic index by comparing the areas under the AUC curve.…”

Predicting Values of Neutrophil-to-Lymphocyte Ratio (NLR), High-Sensitivity C-Reactive Protein (hs-CRP), and Left Atrial Diameter (LAD) in Patients with Nonvalvular Atrial Fibrillation Recurrence After Radiofrequency Ablation

“…Many studies have found a strong association of inflammatory marker with risk of AF [ 17 , 18 ], but there is no consensus about the predictive role of hs-CRP and NLR in AF recurrence. Yano et al showed NLR was only useful for predicting late AF recurrence in paroxysmal AF [ 19 ]. In the present study, we found that higher hs-CRP and NLR predicted NVAF recurrence 12 months after RFA, regardless of existence of persistent AF and paroxysmal AF.…”

Clinical impact of right ventricular-pulmonary artery uncoupling on predicting the clinical outcomes after catheter ablation in persistent atrial fibrillation patients

“…PerAF patients who underwent an initial ablation were enrolled between May 2017 and Sepember 2020 from the ORAF (Osaka Rosai Atrial Fibrillation ablation) registry [14] , [15] , [16] . In the present study, PerAF was defined as AF persisting for more than 1 week.…”

“…Anticoagulation therapy was started at least 3 weeks before the ablation procedure. Details of the catheter ablation in our laboratory have been published previously [14] , [15] , [16] . One circular mapping catheter was deployed in the superior and inferior pulmonary veins and the left-sided then right-sided ipsilateral pulmonary veins (PVs) were circumferentially ablated guided by three-dimensional left atrium mapping (CARTO3, Biosense-Webster, Diamond Bar, CA, USA).…”