Vlachakis PK, Theofilis P, Kordalis A, Tousoulis D. Systemic immune inflammation index as a predictor for atrial fibrillation recurrence after catheter ablation. World J Cardiol 2025; 17(3): 103993 [DOI: 10.4330/wjc.v17.i3.103993]
Corresponding Author of This Article
Dimitris Tousoulis, Professor, Department of 1st Cardiology, Athens Medical School, National and Kapodistrian University of Athens, Mantouvalou 3, Athens 11527, Greece. drtousoulis@hotmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Mar 26, 2025; 17(3): 103993 Published online Mar 26, 2025. doi: 10.4330/wjc.v17.i3.103993
Systemic immune inflammation index as a predictor for atrial fibrillation recurrence after catheter ablation
Panayotis K Vlachakis, Panagiotis Theofilis, Athanasios Kordalis, Dimitris Tousoulis
Panayotis K Vlachakis, Panagiotis Theofilis, Athanasios Kordalis, Department of 1st Cardiology, General Hospital of Athens “Hippocratio”, University of Athens Medical School, Athens 11527, Greece
Dimitris Tousoulis, Department of 1st Cardiology, Athens Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
Author contributions: Vlachakis PK and Theofilis P conducted the literature search and wrote the original draft; Kordalis A and Tousoulis D supervised and critically revised the manuscript. All authors have read and agreed to the final version.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dimitris Tousoulis, Professor, Department of 1st Cardiology, Athens Medical School, National and Kapodistrian University of Athens, Mantouvalou 3, Athens 11527, Greece. drtousoulis@hotmail.com
Received: December 6, 2024 Revised: February 14, 2025 Accepted: February 25, 2025 Published online: March 26, 2025 Processing time: 105 Days and 10.7 Hours
Abstract
Atrial fibrillation (Afib) is a common arrhythmia with significant public health implications, affecting millions of individuals worldwide. Catheter ablation (CA) is an established treatment for drug-resistant Afib, yet recurrence remains a major concern, impacting quality of life in a significant portion of patients. Inflammation plays a critical role in the recurrence of Afib after ablation, with systemic inflammatory markers such as C-reactive protein being linked to higher recurrence rates. In this editorial, we discuss the study by Wang et al, published in the latest issue, which investigates the predictive role of the systemic immune inflammation index (SII) in Afib recurrence following radiofrequency CA. Elevated pre-ablation SII levels are identified as an independent predictor of recurrence, significantly enhancing the predictive power of the APPLE score. Integration of SII improved the APPLE score’s predictive performance, as shown by enhanced area under the curve, net reclassification improvement, and integrated discrimination improvement. This combined model highlights the importance of both structural and inflammatory factors in Afib recurrence, offering a more personalized approach to patient management. Additionally, the affordability and accessibility of SII enhance its practicality in clinical workflows. The study by Wang et al underscores the potential of integrating SII with existing scoring systems to refine risk stratification and optimize treatment strategies. Future research should validate these findings across diverse populations, explore limitations such as the potential influence of comorbidities on SII reliability, and investigate additional biomarkers to enhance predictive accuracy.
Core Tip: To optimize outcomes after catheter ablation for atrial fibrillation (Afib), understanding predictors of recurrence is crucial. The systemic immune inflammation index (SII) has emerged as a practical tool to identify patients at higher risk. This biomarker, based on neutrophil, lymphocyte, and platelet counts, reflects systemic inflammation-a key driver of atrial remodeling and recurrence. Integrating SII with existing scoring systems, like the APPLE score, enhances risk prediction and allows for personalized treatment strategies, promoting better long-term outcomes and targeted care for Afib patients.
