The value of uric acid/albumin ratio to predict cardioversion success in atrial fibrillation patients

Electrical cardioversion (EC) is a common procedure to restore sinus rhythm after atrial fibrillation (AF). Many factors predict EC success and long-term risk of AF recurrence. Uric acid functions as a pro-oxidant molecule at high concentrations and can trigger AF formation. Uric acid/albumin ratio (UAR) performs better than other inflammatory markers in predicting the development of AF. In this study, we aimed to evaluate the role of UAR in predicting AF recurrence after EC. Patients presenting with paroxysmal AF who underwent EC procedure for the first time were included in this study. The endpoint of the study was successful EC. All patients were monitored during the index hospitalization and routine 24-hour rhythm monitoring was performed at subsequent visits. Patients were divided into two groups according to whether they had successful EC or not. According to our data, successful EC was detected in 49 (61.3%) patients, while AF recurrence was documented in 31 (38.7%) patients during follow-up. Serum uric acid and UAR were significantly lower in patients with successful EC compared to patients with AF recurrence (p<0.05). To determine the UAR cut-off value for detecting EC success, the ROC curve was drawn and the best cut-off value was determined as 1.616 by using the Youden index, (AUC: 0.960, 95% CI: 0.923-0.998, P<0.001). Our findings suggest that UAR plays an independent role in the development of AF following successful EC.