The Uric Acid-to-High-Density Lipoprotein Cholesterol Ratio: A New Biomarker for Predicting Arrhythmia Recurrence After Atrial Fibrillation Ablation

<b>Background:</b> We aimed to assess the uric acid-to-high-density lipoprotein cholesterol (HDL-C) ratio (UHR) and several other parameters with respect to their performance in detecting recurrence among patients with atrial fibrillation (AF) who underwent ablation. <b>Methods:</b> This retrospective cohort study analyzed data from patients who underwent radiofrequency or cryoablation for paroxysmal, persistent, or long persistent AF between September 2021 and September 2023. After ablation, patients were monitored for 24 h, with an ECG Holter used for symptomatic cases. Follow-up visits occurred at 1, 3, and 12 months. Collected data included demographics, comorbidities, echocardiographic measurements, clinical data, ablation type, medication use, and a comprehensive set of laboratory findings. <b>Results:</b> The study included 163 patients, with AF recurrence in 39 (23.93%) patients. Mean age was 57.49 ± 11.22 years, and 59.51% of participants were male. There was no significant difference between recurrent and non-recurrent groups in terms of age or sex distribution. Univariate analysis showed that recurrent patients had significantly larger left atrium diameter, higher percentages of persistent/long AF, and elevated levels of CRP, uric acid, UHR, and uric acid-to-creatinine ratio (UCR). Logistic regression analysis revealed that high left atrium diameter, long persistent AF presence, high CRP and uric acid levels, and high UCR and UHR values greater than 15.1 were independent predictors of AF recurrence. A UHR value of >15.1 was found to predict recurrence with 61.54% sensitivity and 70.97% specificity. <b>Conclusions:</b> Despite low sensitivity, UHR appears to be an independent biomarker that can predict AF recurrence. Including UHR in future risk assessment tools may be beneficial to enhance their accuracy.