Predictive value of the systemic immune inflammation index in recurrence of atrial fibrillation after radiofrequency catheter ablation

Abstract

The recurrence of atrial fibrillation (AF) in patients after successful radiofrequency catheter ablation (RFCA) appears to be an unresolved clinical issue and needs to be clearly elucidated. There are many factors associated with AF recurrence, such as duration of AF, male sex, concomitant heart failure, hemodynamic parameters, chronic obstructive pulmonary disease, hypertension, obstructive sleep apnea, hyperthyroidism, smoking and obesity. However, the inflammatory changes are strongly associated with electrical and structural cardiac remodeling, cardiac damage, myocardial fibrotic changes, microvascular dysfunction and altered reparative response. In this context, biomarkers reflecting the different stages of AF pathogenesis deserve thorough investigation. The authors of the retrospective study revealed that one-year recurrence rate of non-valvular AF in the high systemic immune inflammation (SII) index group was significantly increased compared to that of the low SII index group and provided additional predictive value to the APPLE. Furthermore, the authors suggest that this biomarker may help physicians to optimize the selection of AF patients and to develop a personalized treatment approach. In conclusion, the SII index may serve as a valuable indicator of recurrent AF in patients after RFCA and may be a biomarker with plausible predictive value for poor clinical outcomes.

Keywords: Systemic immune inflammation index; Recurrent atrial fibrillation; Radiofrequency catheter ablation; Biomarkers; APPLE score; Prediction

Core Tip: Elevated systemic immuno-inflammatory index appears to be a strong indicator of recurrent atrial fibrillation in patients after effective radiofrequency catheter ablation and may serve as a biomarker with plausible predictive value for poor clinical outcomes.