Bilirubin Elevation During Hospitalization Post Radiofrequency Catheter Ablation of Persistent Atrial Fibrillation: Variation Trend, Related Factors, and Relevance to 1-Year Recurrence

Abstract

Jia-Meng Shao,* Bing Shen,* Zhi-Xiang Zhou, Lucia D’Angelo, Shea Michaela James, Jia-Feng Lin, Cheng Zheng Department of Cardiology, the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Cheng Zheng; Jia-Feng Lin, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, East Section of Wenzhou Avenue, No. 1111, Wenzhou, Zhejiang Province, 325000, People’s Republic of China, Tel [phone], Email [email protected]; [email protected]: The role of total bilirubin (TBIL) in cardiovascular disease has been increasingly recognized in recent decades. Studies have shown a correlation between total bilirubin levels and the prognosis of patients after heart surgery. This study aimed to investigate the clinical significance of bilirubin elevation in persistent atrial fibrillation (PAF) patients who received radiofrequency catheter ablation (RFCA).Methods and Results: A total of 184 patients with PAF who received RFCA were retrospectively studied. Laboratory examinations and demographic data were analyzed to identify independent predictors of TBIL elevation. The relationship between TBIL and prognosis was further investigated. Our results indicated that TBIL increased significantly after RFCA. Multiple linear regression analysis showed that TBIL elevation owned a negative correlation with the percentile of low voltage areas (LVAs) in left atria (β=− 0.490, P< 0.001). In contrast, a positive correlation was observed with the white blood cell (WBC) ratio (β=0.153, P=0.042) and left atrial diameter (LAD) (β=0.232, P=0.025). It was found that postoperative TBIL levels increased and then gradually decreased to baseline within 5 days without intervention. The bilirubin ratio < 1.211 indicated the possibility of 1-year AF recurrence after ablation with a predictive value of 0.743 (specificity = 75.00%, sensitivity = 66.67%).Conclusion: Bilirubin elevation post PAF RFCA was a common phenomenon and was associated with 1-year recurrence of AF in PAF patients after RFCA.Keywords: bilirubin, atrial fibrillation, radiofrequency catheter ablation, oxidative stress, prognosis

Keywords

• bilirubin
• atrial fibrillation
• radio-frequency catheter ablation
• oxidative stress
• prognosis