Significance of Clinical and Biochemical Markers in Predicting Atrial Fibrillation Recurrence after Catheter Ablation

ORIGINAL ARTICLE
Khasan I. Uralov, Nodir U. Zakirov, Baxtiyor Dj. Amirkulov, Ravshanbek D. Kurbanov

 
For citation: Uralov KhI, Zakirov NU, Amirkulov BDj, Kurbanov RD. Significance of Clinical and Biochemical Markers in Predicting Atrial Fibrillation Recurrence after Catheter Ablation. International Journal of Biomedicine. 2025;15(4):653-659. doi:10.21103/Article15(4)_OA1
 
Originally published December 5, 2025

Abstract: 

Background: Pulmonary vein isolation, particularly via radiofrequency ablation (RFA), is a well-established and effective treatment strategy recommended in international clinical guidelines for patients with symptomatic, drug-resistant atrial fibrillation (AF). This study aimed to investigate the incidence and risk factors of early and late recurrence of AF following RFA.
Methods and Results: This prospective, randomized, open-label study included 67 patients (70.1% male) diagnosed with recurrent AF. Any atrial tachyarrhythmia episode lasting more than 30 seconds was defined as a recurrence.  All patients underwent RFA of the pulmonary veins (without the CARTO system) between 2022 and 2025. Clinical and laboratory parameters were analyzed before ablation for their association with recurrence.
Early recurrence (ER) was observed in 30 (44.8%) patients, while late recurrence (LR) occurred in 32 (47.8%) patients. Multivariate logistic regression revealed that diabetes mellitus and C-reactive protein (CRP) level at the end of the blanking period remained the only independent predictors of ER. CRP levels demonstrated strong predictive value for early recurrences (AUC = 0.93), with a cutoff point of 1.95 mg/L, a sensitivity of 90%, and a specificity of 85.7% (P<0.001). In ROC analysis for CRP and diabetes combined, the AUC reached 0.957, demonstrating a very high discriminative capacity. The sensitivity was 96.7%, and the specificity was 90.9%, confirming the high accuracy and reliability of the prognostic model (P<0.001).
For late recurrence, multivariate logistic regression revealed that CRP, AF duration, left atrial volume index (LAVI), and erythrocyte sedimentation rate (ESR) were identified as independent predictors of the outcome. In the ROC analysis of 12-month recurrence predictors, the model demonstrated strong statistical significance (P=0.000), with an AUC of 0.83. Although ER was not identified as an independent predictor in the logistic regression model, the ROC analysis demonstrated the predictive relevance of CRP, AF duration, LAVI, ESR, and ER rate, with sensitivity exceeding 75% and specificity above 80%
Conclusion: Elevated CRP levels and diabetes are strong independent predictors of early AF recurrence after catheter ablation.  Longer AF duration, larger left atrial size, increased ESR, and early recurrence rate also contribute to late recurrence. Combined clinical and biochemical evaluation may enhance individualized risk stratification and post-ablation management.

Keywords: 
atrial fibrillation • radiofrequency ablation • recurrence • C-reactive protein • diabetes mellitus
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Received October 10, 2025.
Accepted November 20, 2025.
©2025 International Medical Research and Development Corporation.