Abstract 13904: Association Between Pre-Ablation and Post-Ablation Neutrophil-Lymphocyte Ratio and Atrial Fibrillation Recurrence: A Meta-Analysis

Introduction: Recurrence of atrial fibrillation (AF) has become prevalent in patients who have had catheter ablation. A high neutrophil-lymphocyte ratio (NLR) may predict the risk of AF recurrence. However, the research is inconclusive. This meta-analysis examined the importance of easy access and cost-effective pre and post-ablation NLR values as predictors of AF recurrence in post-ablation patients.

Methods: We conducted a literature search in PubMed, SCOPUS, and Google Scholar to identify the relevant studies through May 2023. Random effects models were employed to estimate the pooled odds ratio (OR) of pre and post-NLR and AF recurrence. I2 statistics and leave-one-out sensitivity analysis were used to report inter-study heterogeneity. p<0.05 was significant.

Results: We retrieved 270 studies from the literature search, and seven studies were included in this meta-analysis, in which 1983 participants who had AF recurrence after undergoing ablation were analyzed. There are 5 retrospective and 2 prospective studies with a mean follow-up of 20.5 months. The pooled analysis showed the unadjusted odds ratio (OR) of AF recurrence for pre-ablation NLR as 1.33 (95% CI: 1.04-1.71, p<0.01, I2 = 95.49%) and the adjusted OR as 1.45 (95% CI: 0.87-2.43, p<0.01, I2 = 95.1%) (Fig. 1). For post-ablation NLR, the unadjusted OR was 1.21 (95% CI:1.09-1.36, p<0.01, I2 = 85.9%), and the adjusted OR was 1.28 (95% CI: 0.93-1.76), demonstrating significant heterogeneity (I2 =95.32%) with a p-value of <0.01 (Fig.1).

Conclusion: NLR had a significant association with predicting the recurrence of AF. We recommend clinicians add a simple NLR blood test to their diagnostic modalities to detect AF recurrence.