ABSTRACT
Objective: To explore the predictors in patients of paroxysmal atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA). Methods: A total of 142 PAF patients received RFCA in our hospital from 2013-03 to 2016-03 were studied. The patients were divided into 2 groups: Recurrence group, n=46 and Non-recurrence group, n=96. Clinical data was compared between 2 groups and AF recurrent predictors were studied by single and multivariate Logistic regression analysis. Based on quartiles of uric acid (UA) level, the patients were categorized in another set of 4 groups: Q1 group, UA<259 μmol/L, n=33, Q2 group, UA 259-320 μmol/L, n=37, Q3 group, UA 321-380 μmol/L, n=37 and Q4 group, UA>380 μmol/L, n=35. The influence of UA on AF recurrence was measured by Kaplan-Meier test, the predictive value of UA combining metabolic syndrome (UA+MS) on AF recurrence was studied by ROC curve analysis. Results: The BMI, diabetes, MS, AF duration, CHADS2 score, creatinine, UA and BNP were different between Recurrence group and Non-recurrence group, all P<0.05. Logistic regression analysis indicated that AF duration (OR=1.02,95% CI 1.01-1.03, P=0.002), UA level (OR=1.01, 95% CI 1.00-1.01, P=0.046) and MS (OR=4.73, 95% CI 1.36-16.45, P=0.014) were the independent predictors for AF recurrence. UA quartile analysis indicated that gender, BMI, MS, creatinine, LVEF and the incidence of AF recurrence had signifcant discrepancy by different UA levels, all P<0.05. ROC curve showed that the predictive values for UA+MS in AF recurrence had the sensitivity at 80.4%, specificity at 74.1% (AUC 0.79±0.04, 95% CI 0.71-0.89, P=0.0001), for UA in AF recurrence had the sensitivity at 73.9%, specificity at 57.2% (AUC 0.66, 95% CI 0.56-0.76, P=0.02); UA+MS had the higher predictive value than UA alone, P<0.05. Conclusion: Both UA and MS were related to AF recurrence, high UA level combining MS had certain predictive value for AF recurrence in PAF patients after RFCA.