Atrial fibrillation risk scores to evaluate left atrial substrate based on voltage analysis in long-standing persistent type of arrhythmia
| Autor: | Maciej Wielusiński, Radosław Kiedrowicz, Andrzej Wojtarowicz, Jarosław Kaźmierczak |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
education.field_of_study Receiver operating characteristic business.industry Population Atrial fibrillation medicine.disease Risk Assessment Pulmonary vein Left atrial Predictive Value of Tests Risk Factors Internal medicine Risk stratification Persistent atrial fibrillation Atrial Fibrillation Cardiology medicine Catheter Ablation Humans Heart Atria Cardiology and Cardiovascular Medicine business education Retrospective Studies |
| Zdroj: | Kardiologia polska. 79(5) |
| ISSN: | 1897-4279 |
| Popis: | Background: Pre-ablation identification of left atrial (LA) low voltage areas (LVA) among long-standing persistent atrial fibrillation (LSPAF) population remains challenging. Aims: The aim of the study was to analyze the potential of selected scores originally developed to assess arrhythmia recurrences, thromboembolic complications, or progression from paroxysmal to persistent AF to predict the presence of LA-LVA in LSPAF patients. Methods: One hundred and fifty-two patients underwent pulmonary vein isolation followed by high-density-high-resolution LA voltage mapping. AF risk scores, such as APPLE, ATLAS, CAAP-AF, DR-FLASH, CHA2DS2-VASc, and HATCH were retrospectively calculated. A receiver operating characteristic curve analysis was performed to evaluate the ability of the scores to predict LVA. Results: Low voltage areas were detected in 52% of the patients. 28% of the patients with LVA presented severe global LVA burden, whereas 56% of the patients showed a disseminated pattern of remodeling. CAAP-AF ≥7, DR-FLASH ≥4, and CHA2DS2-VASc ≥3 predicted the presence of LVA, whereas ATLAS ≤7 indicated the absence of LVA. ATLAS ≤8, CAAP-AF ≤9, DR-FLASH ≤4, and CHA2DS2-VASc ≤3 predicted the absence of severe LVA. APPLE ≤3 and CHA2DS2-VASc ≤2 predicted the absence of a LVA disseminated pattern. Among predictive scores, ATLAS (AUC, 0.633, 95% CI, 0.543–0.723, P = 0.004), DR-FLASH (AUC, 0.696; 95% CI, 0.594–0.81; P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|