Red Blood Cell Distribution Width is a Biomarker of Red Cell Dysfunction Associated with High Systemic Inflammation and a Prognostic Marker in Heart Failure and Cardiovascular Disease: A Potential Predictor of Atrial Fibrillation Recurrence

At the beginning of the 21st century, approximately 2.3 million US adults had atrial fibrillation (AF), and there has been a 60% increase in hospital admissions for AF. Given that the expectancy is a continuous increase in incidence, it portends a severe healthcare problem. Considerable evidence supports the immune system and inflammatory response in cardiac tissue, and circulatory processes are involved in the physiopathology of AF. In this regard, finding novel inflammatory biomarkers that predict AF recurrence after catheter ablation (CA) is a prime importance global healthcare problem. Many inflammatory biomarkers and natriuretic peptides came out and were shown to have predictive capabilities for AF recurrence in patients undergoing CA. In this regard, some studies have shown that red blood cell distribution width (RDW) is associated with the risk of incident AF. This review aimed to provide an update on the evidence of the RDW as a biomarker of red cell dysfunction and its association with high systemic inflammation, and with the risk of incident AF. Through the literature review, we will highlight the most relevant studies of the RDW related to AF recurrence after CA. Many studies demonstrated that RDW is associated with all cause-mortality, heart failure, cardiovascular disease, and AF, probably because RDW is a biomarker of red blood cell dysfunction associated with high systemic inflammation, reflecting an advanced heart disease with prognostic implications in heart failure and cardiovascular disease. Thus, suggesting that could be a potential predictor for AF recurrence after CA. Moreover, the RDW is a parameter included in routine full blood count, which is low-cost, quick, and easy to obtain. We provided an update on the evidence of the most relevant studies of the RDW related to AF recurrence after CA, as well as the mechanism of the high RDW and its association with high systemic inflammation and prognostic marker in cardiovascular disease and heart failure.