The Correlation Study Between NLR、LAD、LVEF And Recurrence After Catheter Radiofrequency Ablation In Patients With Atrial Fibrillation

BackgroundThe rapidly developing radiofrequency catheter ablation(RFCA)has become an important method for the radical treatment of atrial fibrillation(AF),but some patients still face the risk of postoperative recurrence.Identifying high-risk patients for recurrence through risk factors and clinical indicators has become a hot topic in clinical research on atrial fibrillation.Neutrophil to lymphocyte ratio(NLR)is a new type of complex inflammation indicator that is currently being discussed and closely related to the development and prognosis of various cardiovascular diseases.In clinical practice,doctors often indirectly evaluate the function and structure of the heart through cardiac ultrasound to determine the prognosis of the disease.Left atrial diameter(LAD)enlargement and left ventricular ejection fraction(LVEF)decrease in patients with atrial fibrillation often indicate cardiac structural remodeling,functional abnormalities,and poor prognosis.Early detection of recurrence risk factors and effective intervention to reduce recurrence rate and improve the comprehensive prevention and treatment level of atrial fibrillation.ObjectiveExploring the correlation between peripheral blood neutrophil to lymphocyte ratio(NLR)levels,left atrial diameter(LAD),left ventricular ejection fraction(LVEF),and recurrence after catheter radiofrequency ablation in patients with atrial fibrillation,and identifying high-risk patients for recurrence through these indicators,timely intervention,and improving surgical success rate.MethodsThis study included 152 patients with paroxysmal and persistent atrial fibrillation who received their first catheter radiofrequency ablation treatment at Huaihe Hospital of Henan University from September2020 to July 2022.Improve current medical history,past history,blood routine examination at admission and postoperative(2-3 days),liver function,renal function,and other serological indicators,as well as echocardiography,and calculate the difference in NLR between post ablation and pre ablation ΔNLR.Follow up and record the electrocardiogram,blood routine,and cardiac ultrasound after 6 months.According to the recurrence status,patients were divided into a recurrence group(n=36)and a non recurrence group(n=116).Compare the differences in peripheral blood NLR,LAD,and LVEF between the two groups of patients,and use univariate and multivariate logistic regression analysis to determine whether they are relevant indicators for predicting postoperative recurrence.Results1.During the 6-month follow-up period,36 patients experienced postoperative recurrence,while 116 patients did not.There was no significant difference between the recurrent group and the non recurrent group in gender,age,type of atrial fibrillation,liver function,renal function,hypertension,diabetes,cerebrovascular disease,etc.(P>0.05).There was a statistically significant difference in preoperative lymphocyte count between the two groups of patients [1.50(1.03,1.76)vs 1.69(1.36,2.14)P=0.006].Two groups of patients had preoperative NLR [3.24(2.00,5.80)vs 2.10(1.60,3.39)P=0.002],There was a statistically significant difference between ΔNLR [1.99(-0.20,3.35)vs 0.27(-0.58,1.55)P=0.002] and postoperative NLR [5.27(4.59,6.61)vs 3.74(1.56,3.92)P<0.001].In the recurrence group,preoperative NLR,postoperative NLR,and ΔNLR comparison showed no statistically significant difference(P>0.05).The comparison of preoperative left atrial diameter between two groups of patients(42.47 ± 4.22(mm)vs39.45 ± 4.80(mm),P <0.001)showed statistically significant differences.The comparison of preoperative left ventricular ejection fraction between the two groups of patients(55.50 ± 7.15(%)vs 59.54 ± 6.98(%),P =0.003)showed statistically significant differences.2.In univariate logistic regression analysis,preoperative lymphocytes(OR=0.341,95% CI: 0.166-0.7,P =0.003),preoperative NLR(OR=1.400,95% CI: 1.154-1.698,P =0.001)Δ NLR(OR=1.415,95% CI:1.140-1.757,P =0.002),left atrial diameter(OR=1.146,95% CI: 1.053-1.246,P =0.002),and left ventricular ejection fraction(OR=0.925,95% CI: 0.877-0.976,P =0.004)are related factors that affect patient recurrence.3.Multivariate logistic regression results showed that preoperative NLR(OR=3.125,95% CI:2.010-4.860,P <0.001),Δ NLR(OR=3.047,95% CI: 1.950-4.760,P <0.001),left atrial diameter(OR=1.117,95% CI: 1.002-1.246,P =0.046),left ventricular ejection fraction(OR=0.915,95% CI:0.850-0.985,P =0.018)are independently associated with recurrence of atrial fibrillation after radiofrequency ablation.4.After six months of postoperative follow-up,it was found that the left atrial size [39.45 ± 4.80(mm)vs 36.97 ± 5.49(mm),P <0.001] and left ventricular ejection fraction [59.54 ± 6.98(%)vs 61.21 ± 6.00(%),P =0.012] in the sinus rhythm group showed significant improvement.The degree of mitral regurgitation was improved in both the recurrent and non recurrent groups of patients.Conclusion1.The recurrent group had a higher preoperative NLR,Δ NLR and postoperative NLR compared to the non recurrent group.Compared with the sinus rhythm group,the recurrent group had a larger preoperative left atrial diameter and lower left ventricular ejection fraction.2.Preoperative NLR,Δ NLR,left atrial diameter and left ventricular ejection fraction are independently associated with postoperative recurrence of atrial fibrillation after radiofrequency ablation.They are part of the predictive risk factors for recurrence after radiofrequency ablation of atrial fibrillation.