Pre-Ablation Serum Biomarkers Associated With Atrial Fibrillation Recurrence: A Systematic Review and Meta-Analysis to Improve Patient Selection for Catheter Ablation

Atrial fibrillation is a common arrhythmia whose recurrence after ablation may be predicted by serum biomarkers, highlighting the need to consolidate evidence to improve patient selection. The objective was to identify pre-ablation serum biomarkers associated with atrial fibrillation recurrence after catheter ablation. A systematic review and meta-analysis were conducted according to the PRISMA guidelines, with searches performed in PubMed, Embase, and Scopus using the descriptors “Catheter Ablation,” “Biomarkers,” and “Atrial Fibrillation,” combined with the Boolean operators AND/OR. Thirty studies were included, most of which demonstrated good methodological quality. Inflammatory biomarkers and composite scores showed promising results, whereas clinical factors, ablation strategies, pharmacological interventions, technical aspects, and risk and artificial intelligence models showed heterogeneous findings. The findings indicated the potential of biomarkers and predictive tools to improve recurrence risk stratification. However, pre-ablation serum biomarkers, combined with clinical factors and predictive models, may assist in patient selection and individualized management for ablation, although the heterogeneity of the evidence requires validation in multicenter studies.