Validation of seven risk scores in a prospective and independent cohort: the challenge of predicting recurrence after atrial fibrillation ablation
| Autor: | K Filipovic, S Dittrich, C Scheurlen, Z Arica, S Erlhoefer, J Woermann, JH Van Den Bruck, A Sultan, D Steven, J Lueker |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | EP Europace. 24 |
| ISSN: | 1532-2092 1099-5129 |
| Popis: | Funding Acknowledgements Type of funding sources: None. Background Several predictive scores for atrial fibrillation (AF) recurrence after ablation have been developed, only some of these are validated in prospective cohorts. The predictive value of such scores has thus far been limited, and many have not been compared with one another. Aims We sought to compare the predictive value of seven previously described risk scores ((CHA2DS2 and CHA2DS2-VASC, HATCH, APPLE, CAAP-AF, BASE-AF2, MB-LATER) for prediction of AF recurrence risk at 12 months after AF ablation. Further, we aimed to identify additional variables to predict recurrences after AF ablation. Methods We analyzed data from of our prospective digital AF ablation registry to compare the previously published scores in an independent and prospective cohort (n=883, 50.8% with paroxysmal AF). Patients were undergoing de-novo ablation of AF received a pulmonary vein isolation (PVI) using radiofrequency (RF) ablation or cryoablation. Ablation procedures for recurrences of AF after initial PVI included re-isolation of the pulmonary veins by RF ablation, with additional substrate modification at the operators’ discretion. Early recurrence and recurrence after ablation were defined as any AF or atrial tachycardia episode lasting ≥ 30 s in the first 3 months after ablation and from the end of the 3-month period to 12 months after ablation. Follow-up of patients was scheduled at regular intervals 3 and 12 months after ablation, and included Holter-ECG, 12-lead ECG and history. Outcome-relevant data from implanted cardiac devices (CIED), such as 2-chamber ICD and pacemakers, or implantable loop recorders were analyzed when available. A predefined subgroup analysis was performed in the following subgroups: first procedure vs. redo procedure, paroxysmal vs. persistent AF, and RF ablation vs. cryoablation. Results The BASE-AF2 (AUC 0.630, p Conclusion Despite numerous available scores, predicting recurrences after AF ablation remains challenging. New simple and robust predictors are needed, potentially based on diagnostic interventions, as well as novel genetic, functional and anatomic parameters. |
| Databáze: | OpenAIRE |
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