title: Red blood cell distribution width predicts outcome of cryoballoon-based atrial fibrillation ablation.
abstract: OBJECTIVE
  Elevated red blood cell distribution width (RDW) has been associated with atrial fibrillation (AF) in cross-sectional and prospective studies. In this study, we aim to evaluate the relation of preablation RDW levels to late AF recurrence following cryoablation.
  
  
  METHODS
  A total of 299 patients with symptomatic paroxysmal or persistent AF despite ≥ 1 antiarrhythmic drug(s) who were scheduled for cryoballoon-based AF ablation were enrolled in this prospective study.
  
  
  RESULTS
  A total of 299 patients (55.40 ± 10.60 years, 49.20 % male) were involved and followed up at a median time of 24 (6-44) months. Patients with late AF recurrence had higher RDW levels (14.30 ± 0.93 vs. 13.52 ± 0.93 %, p < 0.001). Multivariate Cox proportional hazard regression analysis showed that RDW level was an independent predictor for late AF recurrence (HR 1.88, 95 % CI 1.41-2.50, p < 0.001) along with left atrial (LA) diameter (HR 3.09, 95 % CI 1.81-5.27, p < 0.001), duration of AF (HR 1.04, 95 % CI 1.01-1.07, p = 0.02), and early AF recurrence (HR 6.39, 95 % CI 3.41-11.97, p < 0.001). A cut-off level of 13.75 % for RDW predicted late AF recurrence following cryoballoon-based pulmonary vein isolation (PVI) with a sensitivity and specificity of 78.00 and 70.00 %, respectively.
  
  
  CONCLUSIONS
  These findings suggest that elevated RDW may be a predictor of late recurrence following cryoballoon-based AF ablation. Further studies are needed to establish its exact pathophysiologic and prognostic roles.
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Kadri Murat
authors.initials: KM
authors.lastname: Gurses
authors.forename: Muhammed Ulvi
authors.initials: MU
authors.lastname: Yalcin
authors.forename: Duygu
authors.initials: D
authors.lastname: Kocyigit
authors.forename: Banu
authors.initials: B
authors.lastname: Evranos
authors.forename: Ahmet Hakan
authors.initials: AH
authors.lastname: Ates
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yorgun
authors.forename: Mehmet Levent
authors.initials: ML
authors.lastname: Sahiner
authors.forename: Ergun Baris
authors.initials: EB
authors.lastname: Kaya
authors.forename: Necla
authors.initials: N
authors.lastname: Ozer
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Oto
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
mesh_terms: D001281:Atrial Fibrillation / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D048429:Cell Size; D004906:Erythrocyte Count / Q000706:statistics & numerical data; D004909:Erythrocyte Indices; D004912:Erythrocytes / Q000166:cytology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D012008:Recurrence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology