Association Between HALP Score and Atrial Fibrillation Recurrence After Radiofrequency Catheter Ablation

Radiofrequency catheter ablation (RFCA) is the primary treatment for atrial fibrillation (AF), but recurrence rates remain high. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score reflects inflammation and nutrition, yet its prognostic value for AF recurrence remains unclear.

We retrospectively reviewed 877 patients with AF undergoing first RFCA. Patients were divided into four quartiles (Q1-Q4) based on preoperative HALP scores. Recurrence-free survival was estimated by Kaplan-Meier curves. Multivariate Cox models assessed the independent link between HALP scores and AF recurrence. Restricted cubic spline (RCS) analysis was conducted to explore the dose-response relationship. Model discrimination and reclassification were assessed using receiver operating characteristic (ROC) curve analysis, net reclassification improvement (NRI), and integrated discrimination improvement (IDI).

A total of 686 patients with AF (mean age: 63.4 ± 10.7 years; 55.5% male) were included in the final analysis. The risk of AF recurrence demonstrated an inverse trend across HALP score quartiles (log-rank p < 0.001). After adjustment, patients in Q3 (HR = 0.45, 95% CI: 0.27-0.75) and Q4 (HR = 0.18, 95% CI: 0.08-0.38) had lower recurrence rates than those in Q1. RCS analysis revealed a linear inverse association between HALP score and the risk of AF recurrence. ROC analysis demonstrated that the HALP score alone exhibited significant discriminatory ability (AUC = 0.71, 95% CI: 0.66-0.75). Notably, incorporating the HALP score into a baseline model of 15 variables significantly improved model discrimination, increasing the AUC from 0.78 to 0.81 (p < 0.001). Furthermore, the addition of HALP score yielded significant improvements in reclassification (NRI = 0.19, IDI = 0.04; both p < 0.001).

Preoperative HALP score is independently linked to AF recurrence after RFCA. Lower scores correspond to higher recurrence risk, suggesting its potential for enhanced risk stratification when combined with conventional clinical factors.