The association between hyperuricemia and atrial fibrillation recurrence after catheter ablation

• Published in: Journal of arrhythmia Vol. 40; no. 3; pp. 520 - 526
• Main Authors: Oseto, Hirotsuna, Yamashita, Seigo, Tokuda, Michifumi, Sato, Hidenori, Shiomi, Satoko, Sakurai, Ryutaro, Yokoyama, Masaaki, Tokutake, Kenichi, Katoh, Mika, Miyanaga, Satoru, Yoshimura, Michihiro, Yamane, Teiichi
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.06.2024; John Wiley and Sons Inc; Wiley
• Subjects: Ablation; atrial fibrillation; Blood; Body mass index; Cardiac arrhythmia; catheter ablation; Catheters; Ejection fraction; Electrocardiography; hyperuricemia; Original; Patients; Peptides; Software; Uric acid; hyperuricemia; atrial fibrillation; catheter ablation; uric acid
• ISSN: 1880-4276; 1883-2148
• DOI: 10.1002/joa3.13030

Background Hyperuricemia (HU) has been reported to be associated with a high incidence of atrial fibrillation (AF). However, the relationship between HUA and recurrent AF after catheter ablation (CA) is unclear. Methods Four hundred consecutive AF patients (paroxysmal/persistent AF [PAF/PsAF]: 200/200) who underwent the initial CA were retrospectively enrolled. HU was defined as serum uric acid (SUA) level >7.0 mg/dL. We measured SUA levels 1 day before (pre‐CA) and 1 month after CA (post‐CA). A second‐generation 28 mm cryoballoon was used for pulmonary vein isolation (PVI) for PAF, while PVI plus linear ablation (roof and mitral isthmus lines) by radiofrequency catheter was conducted for PsAF. Results During 57 ± 24 months of follow‐up, AF recurred in 16% and 42% in PAF and PsAF patients (p < .0001). Pre‐CA SUA level in PsAF was significantly higher than that in PAF (6.5 ± 1.3 vs. 5.8 ± 1.3 mg/dL, p < .001). SUA level was significantly decreased after CA in both PAF and PsAF (5.8 ± 1.3 vs. 5.6 ± 1.3 mg/dL; p < .01 and 6.5 ± 1.3 vs. 6.1 ± 1.2 mg/dL; p < .0001, respectively). The association between pre−/post‐CA HU and recurrent AF was not identified in PAF, while the incidence of post‐CA HU was significantly higher in patients with recurrent AF than those without in PsAF (36% vs. 15%, p < .001). In multivariable analysis, longer AF duration and the presence of post‐CA HU were identified as independent predictors of AF recurrence in PsAF (OR:1.01, 95%CI:1.003–1.011, p = .0001 and OR:2.77, 95%CI:1.333–5.755, p = .007, respectively). Conclusions SUA level was significantly higher in PsAF than PAF patients. The presence of post‐CA HU was strongly related to AF recurrence in PsAF patients. Baseline serum uric acid (SUA) level was significantly higher in PsAF patients than PAF patients. SUA level was significantly decreased at 1‐month after catheter ablation (CA) in both PAF and PsAF. The presence of hyperuricemia (HUA: >7 mg/dL) at 1‐month after CA was strongly associated with AF recurrence in PsAF, but not in PAF.