Circulating intermediate monocytes and atrial structural remodeling associated with atrial fibrillation recurrence after catheter ablation

Abstract Background Inflammation, such as that associated with intermediate CD14 ++ CD16 + monocytes and atrial structural remodeling (SRM), may be important in the recurrence of atrial fibrillation (AF) after catheter ablation. However, the relationship between the intermediate CD14 ++ CD16 + monocytes, SRM, and AF recurrence is unclear. Methods Twenty‐four patients with AF were enrolled. The proportion of intermediate monocytes (PIM) was assessed before ablation by flow cytometry. As a surrogate marker of SRM, the volume ratio (VR) of signal intensity greater than 1 standard deviation on late‐gadolinium enhancement magnetic resonance imaging (LGE‐MRI) was calculated. We investigated whether PIM correlated with SRM on LGE‐MRI and determined the optimal cutoff value for predicting AF recurrence. Results Univariate analysis revealed positive correlations between PIM and BNP with SRM (PIM: r = .593, p = .002; BNP: r = .567, p = .004). Multivariable analysis revealed that PIM was independently associated with VR on LGE‐MRI ( β = .522; p = .033). The finding of an area under the receiver operating characteristic curve of 0.750 revealed that a VR ≥ 13.3% on LGE‐MRI as the optimal cutoff value to predict AF recurrence with 80% sensitivity and 71% specificity, which was associated with PIM ≥ 10.0%. Conclusion Intermediate monocytes were significantly positively correlated with SRM. PIM ≥ 10% was associated with a VR ≥ 13.3% on LGE‐MRI, which predicted AF recurrence after catheter ablation.