C-reactive protein-albumin-lymphocyte index and atrial fibrillation recurrence after radiofrequency ablation in heart failure.

Atrial fibrillation (AF) frequently coexists with heart failure (HF), and predicting post-ablation recurrence remains challenging. This study evaluated the association between the C-reactive protein-albumin-lymphocyte (CALLY) index and post-ablation AF recurrence. We enrolled 159 patients who underwent first-time ablation. Over 12 months, 28.9% experienced recurrence. Associations were tested using Cox regression, Kaplan-Meier curves, restricted cubic splines (RCSs), receiver operating characteristic analysis, and subgroup analyses, with confirmation in an external cohort. Forty-six patients (28.9%) recurred. After multivariable adjustment, the highest CALLY index quartile had lower recurrence risk than the lowest (hazard ratio [HR] = 0.203; 95% confidence interval [CI]: 0.067-0.615; p = 0.005). Recurrence decreased with higher CALLY index values, and RCS analysis suggested an approximately linear inverse relationship (p for overall = 0.025; p for nonlinear p = 0.491). Discrimination was good (area under the curve [AUC] 0.796). External validation was consistent.