Bilirubin Elevation During Hospitalization Post Radiofrequency Catheter Ablation of Persistent Atrial Fibrillation: Variation Trend, Related Factors, and Relevance to 1-Year Recurrence

Figures & data

Figure 1 Left atrial (LA) voltage mapping from 2 patients. The area of voltage <0.5 mV was used to define scar tissue (<0.5 mV – red, green, and blue on the map) and normal tissue (>0.5 mV – purple on the map). A1 and B1 were in the anteroposterior (AP) projection. A2 and B2 were in the posteroanterior (PA) projection. Patient 1 (A1-A2) had better substrate in LA, and the LVA (30.6%) was limited. Patient 2 (B1-B2) had widespread LVA (79.2%).

Table 1 Demographic and Clinical Characteristics of Patients [n (%), ]

	Pre-Procedure (Initial) Data	Post-Procedure Data	The Ratio of Data*	P value
Age (years)	65.56±10.65	/	/	/
Male	135 (73.37)	/	/	/
Body mass index (kg/m^2)	24.88±3.27	/	/	/
Average in-hospital day (days)	6.19±0.976
Hypertension	95 (51.63)	/	/	/
Diabetes	24 (13.04)	/	/	/
Heart failure	4 (2.17)	/	/	/
Coronary artery disease	16 (8.70)	/	/	/
Drinking	45 (24.46)	/	/	/
Smoking	48 (26.09)	/	/	/
Glycosylated hemoglobin (%)	5.94±0.76	/	/	/
LAD (mm)	42.06±5.65	/	/	/
LVEF (%)	62.16±10.16	/	/	/
Time of operation (min)	161.92±42.98	/	/	/
Percent of LVAs (%)	33.3±6.685
WBC (10^9/L)	6.59±1.87	8.90±2.76	1.40±0.46	<0.01
HB (g/L)	141.08±17.16	128.79±16.13	0.91±0.06	<0.01
PLT (10^9/L)	209.72±56.91	178.30±50.16	0.86±0.11	<0.01
ALT (U/L)	31.02±28.60	33.72±31.36	1.22±0.53	<0.01
TBIL (μmol/L)	15.96±9.42	23.90±13.80	1.58±0.64	<0.01
SCR (μmol/L)	81.66±26.47	70.57±21.04	0.88±0.12	<0.01
BUN (mmol/L)	6.87±2.12	6.00±1.67	0.90±0.19	<0.01

Notes: *= postoperative data divided by preoperative data. Correlation test of preoperative and postoperative data. Quoted for the analysis of paired samples T-test or Wilcoxon rank sum test for continuous or categorical variables, respectively.

Abbreviations: LAD, left atrial diameter; LVEF, left ventricular ejection fraction; LVAs, low voltage areas; WBC, white blood cell; HB, hemoglobin; PLT, platelets; ALT, alanine aminotransferase; TBIL, total bilirubin; SCR, serum creatinine; BUN, blood urea nitrogen.

Figure 2 Change trend of bilirubin before and after RFCA.

Notes: ***=P < 0.001, **=P < 0.01.

Abbreviation: NS, no statistical difference.

Table 2 Multiple Linear Regression Analysis of Total Bilirubin Levels in AF Patients

	Beta	t	P value
Age	−0.043	−0.560	0.576
HbA1c	0.074	0.989	0.324
Ratio of WBC	0.153	2.047	0.042
Ratio of HB	0.034	0.451	0.653
Ratio of PLT	−0.109	−1.439	0.152
Ratio of ALT	0.052	0.685	0.494
Ratio of SCR	−0.087	−1.169	0.244
Ratio of BUN	−0.024	−0.324	0.746
LAD	0.232	2.256	0.025
Percent of LVAs	−0.490	−4.783	<0.001

Abbreviations: HbA1c, hemoglobin A1C; WBC, white blood cell; HB, hemoglobin; PLT, platelets; ALT, alanine aminotransferase; SCR, serum creatinine; BUN, blood urea nitrogen; LAD, left atrial diameter; LVAs, low voltage areas.

Table 3 Recurrence of Atrial Fibrillation in the Two Bilirubin Ratio Groups

Long-Term Prognosis	The Ratio of Bilirubin
	<1.43 (n=92)	≥1.43 (n=92)
Relapse	37	11
Sinus rhythm maintenance	55	81
Recurrence rate	0.40	0.12

Figure 3 The cutoff for the ratio of total bilirubin to predict atrial fibrillation recurrence by receiver operating characteristic (ROC) analysis.