Inflammation and autoimmune responses play an important role in recurrence of atrial fibrillation (AF). Serum globulin levels are a commonly used clinical index that represents inflammation and autoimmune response. This study aimed to determine the relationship between baseline serum globulin levels and the risk of recurrence after ablation in lone AF patients.
We enrolled 348 lone AF patients undergoing radiofrequency catheter ablation for the first time for whom complete follow-up data were available. Pre-ablation peripheral venous blood samples were obtained for measurement of serum globulin levels.
During the follow-up period of 22 months (range, 6–62), AF recurred in 129 patients (37.1%). Recurrence was associated with a low level of pre-ablation serum globulins. Multiple Cox proportional hazard regression analysis showed that persistent AF, AF duration, left atrial diameter, no amiodarone after ablation, and the serum globulin level in particular were independent predictors of AF recurrence. According to receiver operating characteristic curve analysis, the best diagnostic cut-off serum globulin level was 25.4 g/L, which showed 74.4% sensitivity, 71.3% specificity, and 73.3% accuracy.
The baseline low serum globulin level is associated with AF recurrence after first-time ablation in lone AF patients. Therefore, it may be used as a predictor of AF recurrence in these patients.
炎症和自身免疫反应在心房颤动(AF)复发中起重要作用。血清球蛋白水平是一种常用的代表炎症和自身免疫反应的临床指标。本研究旨在确定孤立性心房颤动患者基线血清球蛋白水平与消融术后复发风险之间的关系。
我们纳入了348例首次接受射频导管消融且有完整随访数据的孤立性心房颤动患者。获取消融前外周静脉血样本以测量血清球蛋白水平。
在22个月(范围为6 - 62个月)的随访期间,129例患者(37.1%)心房颤动复发。复发与消融前血清球蛋白水平低有关。多因素Cox比例风险回归分析显示,持续性心房颤动、心房颤动持续时间、左心房直径、消融后未使用胺碘酮,尤其是血清球蛋白水平是心房颤动复发的独立预测因素。根据受试者工作特征曲线分析,最佳诊断临界血清球蛋白水平为25.4 g/L,其敏感度为74.4%,特异度为71.3%,准确度为73.3%。
孤立性心房颤动患者首次消融后基线血清球蛋白水平低与心房颤动复发相关。因此,它可作为这些患者心房颤动复发的预测指标。