Aim: The aim of this study is to investigate the value of inflammatory markers for atrial fibrillation (AF) recurrence prediction after cryo-balloon ablation (CA).Materials & methods: The study included 399 patients divided into two groups by AF recurrence after CA. Inflammatory markers including uric acid/albumin ratio (UAR), systemic immune inflammation index (SIII) and CRP/albumin ratio (CAR) were evaluated.Results: UAR, SIII, and CAR were independently associated with the risk of recurrence in AF patients following CA. In ROC curve analysis, CAR had a greater area under curve (AUC:0.73) value than either SIII (AUC:0.68) or UAR (AUC:0.64).Conclusion: Our study results indicate that CAR compared with SIII and UAR had a greater predictive value than others inflammatory markers in predicting AF recurrence post-CA.

Background Malnutrition is common among elderly patients, often leading to severe complications. This study sheds light on the connection between malnutrition and the occurrence of atrial high-rate episodes (AHREs) and atrial fibrillation (AF), as well as all-cause mortality, in individuals aged 80 and older (octogenarians) with dual-chamber permanent pacemakers (DCPM). We employed the Controlling Nutritional Status (CONUT) score and Prognostic Nutritional Index (PNI) to assess malnutrition status effectively. Methods In this comprehensive retrospective analysis, we evaluated 324 octogenarians who underwent DCPM implantation and received consistent long-term monitoring at a leading tertiary cardiac clinic. Participants were classified into three nutritional status categories based on their CONUT scores. Results During long-term follow-up, the incidence of AHREs did not differ significantly across CONUT score categories; however, AF and the combined endpoint of AHREs + AF were significantly higher in the moderate-to-severe malnutrition group (p < 0.001). Long-term mortality rates increased progressively from normal CONUT scores to moderate-to-severe scores. In the adjusted Cox model, mild malnutrition was associated with a 3.6-fold increased risk of mortality (95% CI: 2.2–14.2), while moderate-to-severe malnutrition conferred a 6.0-fold increased risk (95% CI: 3.4–20.4). Mortality risk rose consistently with worsening nutritional status, with multivariable-adjusted hazard ratios of 3.2 (95% CI: 1.6–11.6) and 5.4 (95% CI: 3.0–19.6) for mild and moderate-to-severe malnutrition, respectively. The CONUT score demonstrated superior predictive value compared with the PNI for both AHREs/AF (AUC 0.73 vs. 0.69) and all-cause mortality (AUC 0.67 vs. 0.61). Conclusion Malnutrition, as assessed by the CONUT score, is independently associated with long-term AHREs + AF and all-cause mortality in octogenarians undergoing standard pacemaker follow-up, with the CONUT score demonstrating greater predictive accuracy than the PNI.

The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score has gained interest as a potential predictive biomarker for various clinical outcomes across multiple diseases. This study aimed to evaluate the efficacy of the HALP score in predicting the recurrence of atrial fibrillation (AF) following cryo-balloon ablation (CBA). A total of 399 patients who underwent CBA for AF were included in the study. Patients were divided into three equal groups based on their HALP scores, and post-procedural AF recurrence was evaluated retrospectively across these groups. After adjusting for confounding independent variables, patients in Tertile 1 had 2.1-fold higher rate of AF recurrence compared to those in Tertile 3, which served as the reference group. Receiver operating characteristic (ROC) curve analysis showed that the HALP score predicted AF recurrence with an area under the curve (AUC) of 0.69, 65% sensitivity, and 65% specificity (hazard ratio [HR]: 0.69, 95% confidence interval [CI]: 0.63-0.74, P < 0.001). This study suggests that the HALP score may serve as an independent predictor of AF recurrence following CBA.

Background: Right ventricular stroke work index is a useful but invasively measured parameter that can be used to predict right heart failure following continuous-flow left ventricular assist device implantation. Right ventricular contraction pressure index is a novel parameter that was developed to measure right ventricular stroke work index with echocardiography. We aimed to investigate the clinical usefulness of right ventricular contraction pressure index to predict short-term mortality and right heart failure in patients who underwent continuous-flow left ventricular assist device implantation. Methods: A total of 49 patients who participated in institutional advanced heart failure registry and underwent continuous-flow left ventricular assist device implantation with a bridge-to-candidacy indication were analyzed retrospectively. Right ventricular contraction pressure index was calculated using offline measurements. Demographic, clinical and outcome data were obtained from the registry data. Patients were grouped according to right ventricular contraction pressure index quartiles. Results: Patients within the lowest right ventricular contraction pressure index quartile had a trend toward higher short-term mortality (46.2%, p = 0.056) and combined short-term mortality and definitive right heart failure (53.8%, p = 0.054) at 15th day postoperatively. Similarly, short-term survival or survival free of definite right heart failure were significantly lower in the lowest right ventricular contraction pressure index quartile (log-rank p = 0.045 and log-rank p = 0.03, respectively). In a proportional hazards model that included echocardiographic parameters, right ventricular contraction pressure index was an independent predictor for short-term mortality (odds ratio: 6.777, 95% confidence interval: 1.118–41.098, p = 0.037), but not for combined short-term mortality and definite right heart failure. No such associations were found for long-term mortality. Right ventricular contraction pressure index had a statistically significant correlation with invasively measured pulmonary capillary wedge pressure, pulmonary vascular resistance, mean pulmonary pressure, and right ventricular stroke work index. Conclusion: Right ventricular contraction pressure index was found as a useful parameter for determining short-term postoperative mortality in patients undergoing continuous-flow left ventricular assist device implantation.

Predicting thromboembolic events caused by left atrial appendage thrombosis (LAAT) is crucial since it is the most concerning complication of nonvalvular atrial fibrillation (NVAF). The objective of this study was to establish the predictive effectiveness of a novel scoring system known as the CLOTS-AF score in identifying the existence of thrombus using transesophageal echocardiography (TEE) in patients with NVAF and to compare it with the CHA₂DS₂-VASc score. This study was conducted retrospectively with 668 NVAF patients who underwent TEE in a single centre. The patients were categorized into two categories based on the presence or absence of LAAT on TEE. The CLOTS-AF score was computed for all patients, which was then compared to the CHA₂DS₂-VASc score. Thrombus was detected in the left atrial appendage (LAA) of 114 (17%) individuals. The study revealed that the thrombus (+) group had substantially higher CHA₂DS₂-VASc scores and CLOTS-AF scores (3 (2-4); 4 (3-6), p < .001), respectively. Furthermore, the CLOTS-AF score was shown to be a better predictor of LAAT than the CHA₂DS₂-VASc score (AUC: 0.70 vs. AUC: 0.61, p < .001). This study could validate the CLOTS-AF score in an external cohort by demonstrating its significant predictive power and underscoring its vital role in clinical practice.

Background and Objectives: There is a well-established correlation between premature ventricular contractions (PVCs) and atrial fibrillation (AF), with a higher burden of PVCs increasing the likelihood of new-onset AF. This study aims to investigate the impact of heart rate variability (HRV) on the onset of AF in patients with moderate to high burdens of PVCs, as observed through 24 h ambulatory electrocardiogram (ECG) analysis. Materials and Methods: Our study was a retrospective analysis involving 187 patients at a single tertiary center. We analyzed PVC counts from 24 h ECG recordings, categorizing the patients into groups based on whether they developed AF or not. Additionally, we developed a nomogram to estimate the risk of AF development in these patients. Results: A new-onset AF was detected in 16% of the cohort. Analysis of 24 h ambulatory ECG data revealed statistically significant increases in the SDNN index, RMSSD, PNN50, total power (TP), and low-frequency (LF) values in AF patients. To estimate the risk of AF, a risk prediction nomogram was created using high-frequency (HF), LF, SDNN index, and PNN50. Among these variables, PNN50 was identified as the strongest predictor in the multivariable model. Additionally, a decision curve analysis demonstrated that the nomogram offers a net clinical benefit for detecting AF in patients when the baseline threshold risk exceeds 15%. Conclusions: Our study found that among patients with AF who had a moderate to high burden of PVCs using 24 h ambulatory ECGs, several HRV parameters were elevated. This increased autonomic instability may play a role in the development and persistence of AF episodes.