Scoring systems in the prediction of atrial fibrillation recurrence after surgical ablation.

Autor: Lauritzen DJ; Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark., Andersen FT; Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark., Modrau IS; Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark., Christensen TD; Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark., Heiberg J; Centre of Head and Orthopaedics Department of Anaesthesiology, Copenhagen University Hospital, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Journal of cardiac surgery [J Card Surg] 2022 Oct; Vol. 37 (10), pp. 3044-3049. Date of Electronic Publication: 2022 Jul 23.
DOI: 10.1111/jocs.16799
Abstrakt: Introduction: More than every third patient experiences recurrent atrial fibrillation after surgical pulmonary vein ablation. However, it remains challenging to predict who will and who will not experience this event. Scoring systems containing baseline risk factors have been proposed as a complementary tool to identify patients at higher risk of experiencing atrial fibrillation recurrence. Therefore, the aim of this study was to assess the value of the scoring systems APPLE, CHA 2 DS 2 -VASc, and CHADS 2 in predicting atrial fibrillation recurrence following surgical ablation.
Methods: In a retrospective study, we identified all patients undergoing concomitant pulmonary vein ablation during cardiac surgery. APPLE-, CHA 2 DS 2 -VASc-, and CHADS 2 scores were calculated for each patient. Subsequently, the predictive value of the scoring systems on atrial fibrillation recurrence 3-12 months postablation was assessed using receiver operating characteristic curves and logistic regression analyses.
Results: Receiver operating characteristic curves showed the superiority of the APPLE scoring system with an area under the curve of 0.690 compared to 0.571 for CHA 2 DS 2 -VASc and 0.569 for CHADS 2 , p = .01. Using logistic regression analyses, APPLE and CHA 2 DS 2 -VASc were predictors of atrial fibrillation recurrence between 3- and 12 months after surgical ablation (odds ratio [OR] 1.93, 95% confidence interval [CI] 1.39-2.67, p < .01 and OR 1.17, 95% CI 1.01-1.36, p = .04, respectively).
Conclusions: The APPLE scoring system is superior to CHA 2 DS 2 -VASc and CHADS 2 in predicting atrial fibrillation recurrence after surgical ablation. It can be used as a complementary tool to select the right candidates for surgical ablation and identify patients who need more frequent clinical and electrocardiogram controls.
(© 2022 Wiley Periodicals LLC.)
Databáze: MEDLINE
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