Abstract
Background/Objectives: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide, with inflammatory cytokines increasingly implicated in its development, persistence, and post-ablation recurrence. However, prospective perioperative cytokine data from Central Asia are lacking. The objective of the study is to evaluate temporal changes in inflammatory cytokines in AF patients undergoing catheter ablation and assess differences by AF type and recurrence status. Methods: In this prospective observational study conducted at the Syzganov National Scientific Center of Surgery, Almaty, Kazakhstan, 166 AF patients (mean age 66.1 ± 8.2 years; 57.8% male) were enrolled. Serum cytokines were measured using ELISA at baseline, immediately postablation, and at 6 months. Temporal changes were analysed using Friedman and Wilcoxon signed-rank tests, while between-group comparisons used Mann–Whitney U and Kruskal–Wallis tests. Results: IL-1β, IL-6, and IL-17A showed significant temporal changes (all p < 0.001). IL-6 increased immediately after ablation (0.088 to 0.122 pg/mL) before decreasing below baseline at 6 months (0.079 pg/mL). IL-17A progressively declined across all time points (0.073, 0.069, and 0.048 pg/mL). At 6 months, IL-1α levels were higher in primary versus recurrent AF (0.079 vs. 0.067 pg/mL; p = 0.047). Baseline IL-1β and IL-28A differed across AF subtypes (p = 0.040 and p = 0.014). No pre-operative cytokine independently predicted recurrence. Conclusions: AF ablation is associated with distinct cytokine trajectories, particularly for IL-1β, IL-6, and IL-17A. Cytokine profiles vary by AF type and recurrence, highlighting the potential role of immune monitoring in AF management. These findings should be regarded as exploratory and hypothesis-generating.