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

Clin Interv Aging. 2024 May 13:19:817-825. doi: 10.2147/CIA.S461832. eCollection 2024.

Abstract

Background: 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: atrial fibrillation; bilirubin; oxidative stress; prognosis; radiofrequency catheter ablation.

MeSH terms

  • Aged
  • Atrial Fibrillation* / surgery
  • Bilirubin* / blood
  • Catheter Ablation*
  • Female
  • Hospitalization
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Prognosis
  • Recurrence*
  • Retrospective Studies
  • Risk Factors

Grants and funding

This work was supported by the National Natural Science Foundation of China [grant numbers 82070333]; the Zhejiang Provincial Natural Science Foundation [grant number LY21H020011]; the Wenzhou Municipal Science and Technology Commission [grant numbers ZY2020018; grant number Y20220472].