Preoperative CALLY Index and Quantitative Left Atrial Low-Voltage Burden are Associated with Documented Recurrence After First Ablation for Persistent Atrial Fibrillation: A Retrospective Cohort Study.
- 1The First Affiliated Hospital of Anhui University of Science and Technology, Anhui University of Science and Technology, Huainan, Anhui, People's Republic of China.
- 2Department of Cardiology, Shanghai Fengxian District Central Hospital, Shanghai, People's Republic of China.
Abstract
We assessed whether preoperative C-reactive protein-albumin-lymphocyte (CALLY) index and intraoperative left atrial low-voltage area (LVA) burden provide complementary prognostic information after first ablation for persistent atrial fibrillation. This retrospective cohort included 259 patients. The endpoint was first documented atrial fibrillation, flutter, or tachycardia lasting ≥30 s after a 60-day blanking period. ln(1/CALLY) and LVA burden were modeled with natural cubic splines in landmark Cox models; diagnostics prompted an extended model allowing LVA effects to vary with log time. There were 114 recurrences. Both exposures showed nonlinear associations (overall P<0.001; P for nonlinearity=0.011 and 0.004). Relative to the median, the 75th percentile of ln(1/CALLY), where higher values correspond to lower CALLY and a less favorable systemic profile, had HR 1.99 (95% CI 1.47-2.70). Corresponding LVA HRs were 2.41, 4.78, 7.36, and 10.21 at days 90, 150, 240, and 364, although late high-LVA support was sparse. Harrell C increased from 0.648 to 0.819 after adding both markers. Near-12-month performance was similar across fixed Cox, time-varying Cox, and fixed-horizon logistic models. CALLY and LVA burden provided complementary systemic-host and electroanatomic information. Findings are prognostic within the observed operator-directed pathway and require external validation.
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BibTeX
@article{chen2026preoperative,
title = {{Preoperative CALLY Index and Quantitative Left Atrial Low-Voltage Burden are Associated with Documented Recurrence After First Ablation for Persistent Atrial Fibrillation: A Retrospective Cohort Study.}},
author = {Siyu Chen and Zhendong Zhang and Bin Cai and Hongwei Wang and Jiangwei Ma and Guanghao Ge and Huajin Liu},
journal = {International journal of general medicine},
year = {2026},
month = nov,
doi = {10.2147/ijgm.s654511},
url = {https://europepmc.org/article/MED/42999651},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Preoperative CALLY Index and Quantitative Left Atrial Low-Voltage Burden are Associated with Documented Recurrence After First Ablation for Persistent Atrial Fibrillation: A Retrospective Cohort Study.
AU - Siyu Chen
AU - Zhendong Zhang
AU - Bin Cai
AU - Hongwei Wang
AU - Jiangwei Ma
AU - Guanghao Ge
AU - Huajin Liu
PY - 2026
DA - 2026/11/03
JO - International journal of general medicine
DO - 10.2147/ijgm.s654511
UR - https://europepmc.org/article/MED/42999651
AB - We assessed whether preoperative C-reactive protein-albumin-lymphocyte (CALLY) index and intraoperative left atrial low-voltage area (LVA) burden provide complementary prognostic information after first ablation for persistent atrial fibrillation. This retrospective cohort included 259 patients. The endpoint was first documented atrial fibrillation, flutter, or tachycardia lasting ≥30 s after a 60-day blanking period. ln(1/CALLY) and LVA burden were modeled with natural cubic splines in landmark Cox models; diagnostics prompted an extended model allowing LVA effects to vary with log time. There were 114 recurrences. Both exposures showed nonlinear associations (overall P<0.001; P for nonlinearity=0.011 and 0.004). Relative to the median, the 75th percentile of ln(1/CALLY), where higher values correspond to lower CALLY and a less favorable systemic profile, had HR 1.99 (95% CI 1.47-2.70). Corresponding LVA HRs were 2.41, 4.78, 7.36, and 10.21 at days 90, 150, 240, and 364, although late high-LVA support was sparse. Harrell C increased from 0.648 to 0.819 after adding both markers. Near-12-month performance was similar across fixed Cox, time-varying Cox, and fixed-horizon logistic models. CALLY and LVA burden provided complementary systemic-host and electroanatomic information. Findings are prognostic within the observed operator-directed pathway and require external validation.
SN - 1178-7074
ER -