Atrial fibrillation recurrence prediction after radiofrequency ablation for patients with atrial fibrillation and hypertension using the systemic immune inflammation and left ventricular mass indices

Atrial fibrillation (AF) is the most common persistent arrhythmia, with hypertension being an important risk factor. Recurrence after ablation is problematic and affects the prognosis. This study aimed to identify independent risk factors for AF recurrence after catheter ablation in patients with AF and hypertension and to evaluate the predictive value of the systemic immune-inflammation (SII) and left ventricular mass indices (LVMI) for AF recurrence. The preoperative SII and LVMI scores were assessed in patients with AF before undergoing radiofrequency ablation (RFCA), and the restricted cubic spline (RCS) assessed their association with the risk of AF recurrence. Multivariate adjusted logistic regression models determined the relationship between the SII, LVMI, and AF recurrence. The areas under the receiver operating characteristic curves assessed the clinical model, net reclassification improvement (NRI), comprehensive discrimination improvement (IDI), SII, and LVMI values. This retrospective study included 385 patients with AF and hypertension who underwent RFCA at our hospital, including 102 with recurrent AF during a mean follow-up of 25.4 months. RCS analysis showed that the prevalence of recurrent AF increased with the increase in SII ≥391.99×109/L and LVMI ≥81.64 g/m. Inclusion of the SII and LVMI in the APPLE score for AF recurrence after RFCA increased the C statistic from 0.699 to 0.807 (p<0.001), and their inclusion in the clinical model improved the IDI and NRI (both >0, p<0.001).The combined SII and LVMI independently and positively correlated with recurrence after the first RFCA in patients with AF and hypertension and has a high predictive value.Nonlinear associations between LVMI ,SII Receiver operating characteristic (ROC)