Red blood cell distribution width predicts outcome of cryoballoon-based atrial fibrillation ablation

• DOI: 10.1007/s10840-014-9959-y
• Publication Date: 2014-12-15T06:29:44Z
• Authors: Kadri Murat Gurses; Muhammed Ulvi Yalcin; Duygu Kocyigit; Banu Evranos; Ahmet Hakan Ates; Hikmet Yorgun; Mehmet Levent Sah...; Ergun Baris Kaya; Necla Ozer; Mehmet Ali Oto; Kudret Aytemir
• Keywords: Erythrocyte Indices; Male; Erythrocytes; Turkey; Reproducibility of Results; Middle Aged; Prognosis; Sensitivity and Specificity; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Recurrence; Risk Factors; Atrial Fibrillation; Outcome Assessment, Health Care; Catheter Ablation; Erythrocyte Count; Prevalence; Humans; Female; Cell Size

Elevated red blood cell distribution width (RDW) has been associated with atrial fibrillation (AF) in cross-sectional and prospective studies. In this study, we aim to evaluate the relation of preablation RDW levels to late AF recurrence following cryoablation.A total of 299 patients with symptomatic paroxysmal or persistent AF despite ≥ 1 antiarrhythmic drug(s) who were scheduled for cryoballoon-based AF ablation were enrolled in this prospective study.A total of 299 patients (55.40 ± 10.60 years, 49.20 % male) were involved and followed up at a median time of 24 (6-44) months. Patients with late AF recurrence had higher RDW levels (14.30 ± 0.93 vs. 13.52 ± 0.93 %, p < 0.001). Multivariate Cox proportional hazard regression analysis showed that RDW level was an independent predictor for late AF recurrence (HR 1.88, 95 % CI 1.41-2.50, p < 0.001) along with left atrial (LA) diameter (HR 3.09, 95 % CI 1.81-5.27, p < 0.001), duration of AF (HR 1.04, 95 % CI 1.01-1.07, p = 0.02), and early AF recurrence (HR 6.39, 95 % CI 3.41-11.97, p < 0.001). A cut-off level of 13.75 % for RDW predicted late AF recurrence following cryoballoon-based pulmonary vein isolation (PVI) with a sensitivity and specificity of 78.00 and 70.00 %, respectively.These findings suggest that elevated RDW may be a predictor of late recurrence following cryoballoon-based AF ablation. Further studies are needed to establish its exact pathophysiologic and prognostic roles.