Significance of the APPLE score and the monocyte-HDL cholesterol ratio in predicting late recurrence of atrial fibrillation following catheter ablation based on a retrospective study

Objective: Collect the characteristics of patients' baseline data, and explore the predictive factors of late recurrence of atrial fibrillation (AF) after catheter ablation according to whether late recurrence or not. The purpose of this study was to determine the significance of the APPLE score in conjunction with the monocyte-high-density lipoprotein cholesterol ratio (MHR) in predicting the late recurrence of AF after catheter ablation in patients with AF.

Methods: Baseline data were collected to explore the predictors of late recurrence after AF catheter ablation. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to compare the predictive value of MHR, the APPLE score and their combined variables in the late recurrence of AF after catheter ablation.

Results: This is a retrospective study. A total of 438 patients were followed-up, including 303 cases of paroxysmal AF, 135 cases of persistent AF (28 cases of long-term persistent AF) and 115 cases of late recurrence. The Cox multivariate regression analysis revealed that MHR, the APPLE score and early recurrence were independent predictors of the late recurrence of AF. The AUC of the combined variables for predicting late recurrence after catheter ablation in patients with AF was higher than that of MHR and the APPLE score (p<0.05). The ROC AUC of the combined variables in predicting the late recurrence of AF after catheter ablation was 0.733 (p<0.001, 95% CI: 0.660 to 0.806), and the best cut-off point was 0.2711 (sensitivity: 69.20%, specificity: 68.00%).

Conclusions: Early recurrence, MHR and the APPLE score are independent risk factors for the late recurrence of AF after catheter ablation. The combination of the APPLE score with MHR improved the value of predicting the late recurrence of AF after catheter ablation. The combined variables were a predictor of an increased late recurrence rate after catheter ablation for AF when the value was greater than 0.2711.