Catheter ablation, particularly for atrial fibrillation and ventricular ectopy, was associated with a significant early elevation in the systemic immune-inflammation index (p=0.001).
Cohort (n=642)
Does catheter ablation increase the systemic immune-inflammation index (SII) compared to diagnostic EPS in adult patients with cardiac arrhythmias?
Catheter ablation, particularly for atrial fibrillation and ventricular ectopy, induces a significant early systemic inflammatory response as measured by the systemic immune-inflammation index (SII).
Effect estimate: Cohen's d 0.84 (RF-AF) and 1.07 (Cryo-AF)
p-value: p=0.001
Catheter ablation induces controlled myocardial injury and transient endothelial dysfunction, both of which may trigger a systemic inflammatory response. The systemic immune-inflammation index (SII) has emerged as a sensitive biomarker reflecting the interplay between inflammation, thrombosis, and immune regulation; however, its peri-procedural behavior after ablation remains unclear. To evaluate changes in SII following catheter ablation across different arrhythmia subtypes and to determine independent predictors of ΔSII. In this retrospective cohort study, 642 adult patients who underwent catheter ablation between January 2022 and December 2024 were analyzed. Pre-procedural and 1-week post-procedural SII values were compared across diagnostic EPS (non-ablation reference group, n = 93), supraventricular tachycardia (SVT(AVNRT+AVRT), n = 384), atrial fibrillation (AF; RF n = 42 and cryoablation n = 51), atrial tachycardia (AT, n = 37), atrial flutter (AFL, n = 27), and ventricular ectopy (VES, n = 72) groups. Multivariable linear regression assessed predictors of ΔSII. Effect sizes were calculated using Cohen’s d and Hedges’ g. Overall SII increased significantly after ablation (p = 0.001). AF groups demonstrated the strongest effect sizes (RF-AF: d = 0.84; Cryo-AF: d = 1.07). No significant changes were observed after diagnostic EPS or AFL ablation. Regression analysis identified EF (β = − 19.4; p = 0.045), RF-AF (β = 808; p = 0.0016), Cryo-AF (β = 710; p < 0.001), and VES ablation (β = 471; p = 0.036) as independent predictors of ΔSII. Catheter ablation—particularly AF and VES ablation—is associated with significant early SII elevation, independent of conventional inflammatory markers such as CRP. These findings suggest that SII may reflect procedure-related inflammatory burden; however, its prognostic value and clinical utility require validation in prospective outcome-driven studies.
Dural et al. (Fri,) conducted a cohort in Cardiac arrhythmias (n=642). Catheter ablation vs. Diagnostic EPS (non-ablation reference group) was evaluated on Changes in systemic immune-inflammation index (ΔSII) (Cohen's d 0.84 (RF-AF) and 1.07 (Cryo-AF), p=0.001). Catheter ablation, particularly for atrial fibrillation and ventricular ectopy, was associated with a significant early elevation in the systemic immune-inflammation index (p=0.001).