Role of novel indices of systemic inflammation in atrial fibrillation recurrence after cryoballoon pulmonary vein isolation

Aim. To assess the prognostic role of the level of novel systemic inflammation biomarkers in predicting atrial fibrillation (AF) recurrence after the primary cryoballoon pulmonary vein (PV) isolation.

Material and methods. The study included 239 people (mean age, 61 years) who underwent the primary cryoballoon PV isolation. The mean follow-up period was 20 months. The primary endpoint was AF recurrence in the long-term period. The initial levels of systemic inflammation markers were studied.

Results. A total of 167 patients remained under follow-up for >1 year, which was 70% of the initial number of selected patients. Of these, the primary endpoint was detected in 63 patients, while 104 patients remained recurrence-free. Between the groups with and without AF recurrence, there were significant differences in the levels of following markers: Systemic Inflammation Response Index (SIRI) — 0,91 (0,67; 1,1) vs 0,76 (0,55; 1,05), p=0,018; Systemic Inflammation Index (SII) — 410,5 (309,6; 565,1) vs 350,95 (257,1; 462,8), p=0,008, Neutrophilto-Lymphocytes Ratio (NLR) — 1,8 (1,5; 2,5) vs 1,6 (1,3; 2), p=0,002. According to the ROC analysis, the following threshold values of AF recurrence-associated markers were obtained: SIRI >0,841, SII >365,83, NLR >1,6. In the multivariate Cox regression model, SII and NLR remained significant predictors of recurrence.

Conclusion. The SIRI, SII and NLR indices have predictive value for AF recurrence after interventional treatment and can be used to improve the effectiveness of cryoballoon PV isolation.

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