Blood lipid levels and recurrence of atrial fibrillation after radiofrequency catheter ablation: a prospective study.

PURPOSE: The relation between dyslipidemia and atrial fibrillation (AF) development remains controversial. We conducted a prospective study to investigate the association of lipids with the risk of recurrence of AF after radiofrequency catheter ablation (RFCA).

METHODS: This study enrolled 287 consecutive patients who underwent initial circumferential pulmonary vein ablation (CPVA). Fasting levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured at baseline before ablation. Patients were classified according to lipid quartiles. AF recurrence was confirmed by 48-h electrocardiograms at follow-up visits.

RESULTS: A total of 71 patients (24.7%) experienced AF recurrence during 3 to 12 months after ablation. By univariate Cox regression survival analysis, TC (HR, 0.63; 95%CI, 0.48-0.82), LDL-C (HR, 0.61; 95%CI, 0.44-0.84), non-paroxysmal AF type (HR, 2.56; 95%CI, 1.52-4.21), and left atrial diameter (HR, 2.18; 95%CI, 1.46-3.24) were significantly associated with AF recurrence. By multivariate Cox regression survival analysis, lower quartiles of TC (HR, 3.66; 95%CI, 1.56-8.56) and LDL-C (HR, 2.28; 95%CI 1.09-4.77) were associated with higher risk of AF recurrence compared with the highest quartiles. After adjustment by sex, lower TC (HR, 11.70; 95%CI, 2.79-49.13) and LDL-C (HR, 11.00; 95%CI, 2.77-43.72) levels were associated with the recurrence of AF in women, but not in men. HDL-C and TG levels showed no association with AF recurrence in both genders.

CONCLUSIONS: TC and LDL-C levels were negatively correlated with AF recurrence after RFCA in women. HDL-C and TG were not independently associated with AF recurrence in both genders.