The association between hematological inflammatory markers and atrial fibrillation recurrence after radiofrequency ablation

Objective: To investigate the relationship between hematological inflammatory markers and postoperative recurrence in patients undergoing initial radiofrequency ablation for atrial fibrillation (AF). Methods: Patients with AF who underwent their first radiofrequency ablation at a hospital in China were enrolled, and comprehensive clinical data were collected. Multivariable logistic regression analysis assessed the relationship between inflammatory markers and AF recurrence risk. Restricted cubic spline (RCS) analysis was performed to examine potential linear trends. Subgroup analyses evaluated the consistency of results across patient categories. Receiver operating characteristic (ROC) curve analysis compared the discriminatory performance of different inflammatory markers for AF recurrence. Results: = 0.002) were independently associated with higher odds of AF recurrence. RCS analysis demonstrated a linear relationship for these markers. Subgroup analysis revealed no significant interaction among different stratification variables. ROC analyses showed limited discriminative performance for AF recurrence (AUCs 0.519-0.554), with MLR having the numerically highest AUC but remaining close to chance-level discrimination. Conclusion: Elevated levels of the inflammatory markers NLR, NAR, SIRI, and MLR are significantly associated with increased AF recurrence risk following initial radiofrequency ablation. Pre-ablation inflammatory indices should be interpreted as adjunctive markers associated with recurrence, and their potential utility may lie in risk stratification when integrated with established clinical predictors, rather than as standalone predictors.