Pan-immune inflammatory value predicts atrial fibrillation recurrence after direct current cardioversion

Aims: We aimed to determine whether there is a relationship between the pan-immune inflammatory value (PIV) and the recurrence of atrial fibrillation (AF) after successful direct current cardioversion (DCCV). Methods: The study included 113 patients with persistent AF who underwent successful DCCV between 2015 and 2023.Results: During the 12-month follow-up, AF recurrence was observed in 38 patients (33.6%). Median PIV was significantly higher in patients who developed recurrence than in those who maintained sinus rhythm (SR) (416.1 vs. 277.0; p=0.0012). The optimal PIV cut-off value was 318.6, providing 76.3% sensitivity and 36.5% specificity. Cox regression analysis identified PIV (HR 1.736, p=0.0260) and coronary artery disease (CAD) (HR 2.276, p=0.0332) as independent predictors of AF recurrence.Conclusion: As a simple and cost-effective biomarker, PIV is an independent predictor of recurrence after DCCV in patients with persistent AF. These findings suggest its potential use in clinical practice for risk stratification of patients undergoing DCCV, enabling more personalized post-cardioversion management strategies.