Clinical scores for outcomes of rhythm control or arrhythmia progression in patients with atrial fibrillation: a systematic review

Deng, Hai; Bai, Ying; Shantsila, Alena; Fauchier, Laurent; Potpara, Tatjana; Lip, Gregory Y.H.

doi:10.1007/s00392-017-1123-0

Cited by 72 publications

(64 citation statements)

References 76 publications

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“…Similarly, the aforementioned studies did not look at New York Heart Association functional classification and only MB‐LATER evaluated the number of previously failed AAD. Other factors that we analyzed that were not consistently evaluated in previous studies included the presence of variant pulmonary vein anatomy, stroke/TIA, QRS duration on electrocardiogram, glomerular filtration rate, and metabolic syndrome . When metabolic syndrome was evaluated, there was not a clear definition as seen in ALARMEc .…”

Section: Discussionmentioning

confidence: 99%

“…Other factors that we analyzed that were not consistently evaluated in previous studies included the presence of variant pulmonary vein anatomy, stroke/TIA, QRS duration on electrocardiogram, glomerular filtration rate, and metabolic syndrome. 11 When metabolic syndrome was evaluated, there was not a clear definition as seen in ALARMEc. 9 This study was limited by its retrospective nature.…”

Section: Strengths/limitationsmentioning

confidence: 99%

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Patient characteristics as predictors of recurrence of atrial fibrillation following cryoballoon ablation

Bavishi

Kaplan

Peigh

et al. 2019

Pacing Clinical Electrophis

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Background While several studies have evaluated predictors for atrial fibrillation (AF) recurrence following catheter ablation, there are limited data specific to cryoballoon ablation (CBA). Methods We analyzed a prospective registry of patients at a single institution who underwent CBA. Recurrence of AF (RAF) was defined as recurrence of AF by 12‐month follow‐up, excluding the 3‐month blanking period. Univariate analysis was performed to evaluate predictors of RAF. Receiver operating characteristic analysis was used to compare and evaluate the performance of various risk scores for discriminating risk of RAF. Results There were 542 patients included in the analysis with mean age 61.3 ± 10.6 years, 67.9% male, and 51.6% paroxysmal AF (PAF). Overall, only left atrial diameter (LAD) > 40 mm and ERAF (early recurrence of AF within 0‐3 month blanking period) were significant predictors of RAF. In the PAF specific subgroup, LAD > 40 mm, AF duration > 12 months, prior stroke or transient ischemic attack, ERAF, and having previously failed an antiarrhythmic drug were significant predictors of RAF. In persistent AF (PeAF) subgroup, obstructive sleep apnea (OSA) and ERAF were significant predictors of RAF. Out of clinical risk scores tested, BASEAF2 had the highest performance with area under the curve of 0.646 (95% confidence interval [0.548, 0.708]; P < .01). Conclusions In this single‐center retrospective study of CBA, we found only LAD > 40 mm and ERAF to be predictors of RAF. We identified OSA as a potential targetable risk factor in PeAF patients undergoing CBA. Out of risk scores tested for discriminating risk of RAF, BASEAF2 had the best performance.

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Section: Discussionmentioning

confidence: 99%

Section: Strengths/limitationsmentioning

confidence: 99%

Patient characteristics as predictors of recurrence of atrial fibrillation following cryoballoon ablation

Bavishi

Kaplan

Peigh

et al. 2019

Pacing Clinical Electrophis

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“…Several clinical risk scores have been proposed to predict new-onset atrial tachyarrhythmias [18]. However, most were done on small cohorts and had no certain external validation.…”

Section: Discussionmentioning

confidence: 99%

Inflammation and the risk of atrial high-rate episodes (AHREs) in patients with cardiac implantable electronic devices

Pastori

Miyazawa

et al. 2018

Clin Res Cardiol

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IntroductionAtrial high-rate episodes (AHREs) are associated with an increased risk of developing atrial fibrillation and thromboembolism. The characteristics of ‘real world’ patients developing AHREs are poorly known.MethodsWe included 496 consecutive patients with cardiac implantable electronic devices (CIEDs). Primary endpoint was occurrence of AHREs, defined as > 175 bpm and lasting > 5 min, in a median follow-up of 16.5 (IQR 3.9–38.6) months (1082.4 patient-years). We also tested the predictive value of clinical risk scores for AHREs.ResultsMean age was 68.8 ± 14.0 years, and 35.5% were women; AHREs were recorded in 173 patients [34.7%, 16.0%/year, 95% confidence interval (CI) 13.7–18.6]. Multivariable Cox regression analysis showed that age [hazard ratio (HR) 1.020, 95% CI 1.004–1.035, p = 0.011], prior AF (HR 3.521, 95% CI 2.831–5.206, p < 0.001), white cell count (HR 1.039, 95% CI 1.007–1.072, p = 0.016) and high C reactive protein (CRP; HR 1.039, 95% CI 1.021–2.056, p = 0.038) were independently associated with AHREs. ROC curve analysis showed that the APPLE score (C statistic 0.53, 95% CI 0.48–0.59; p = 0.296) ALARMEc score (C statistic 0.51, 95% CI 0.44–0.57; p = 0.810) were non-significantly associated with AHRE. Similar results were obtained for CHADS2 and CHA2DS2VASc scoreConclusionAHREs are common in CIEDs patients, with age, prior AF, inflammatory markers (high CRP, white cell count) being factors associated with AHREs onset. Clinical risk scores showed limited value for AHREs prediction in this cohort.Electronic supplementary materialThe online version of this article (10.1007/s00392-018-1244-0) contains supplementary material, which is available to authorized users.

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“…Having the ability to predict postprocedural recurrence would have an enormous impact on both patient outcomes and cost to the health care system. There have been multiple attempts to predict the recurrence of AF following ablation, utilizing known risk factors from retrospective analyses including type of AF, left atrial diameter, number of antiarrhythmic drugs (AAD) failed, and CHADS 2 or CHADS 2 ‐VASc scores . Winkle et al developed a score for predicting AF recurrence following radiofrequency ablations.…”

Section: Introductionmentioning

confidence: 99%

Stratifying risk of recurrence of atrial fibrillation following balloon cryoablation using the CAAP‐AF risk scoring system

Hamilton

Cooper

Meyers

2019

Pacing Clinical Electrophis

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Objective:To determine if the CAAP-AF tool could be applied to a cohort of patients in the United States undergoing cryoablation or AF utilizing second-generation cryoballoons.Background: Atrial fibrillation (AF) is a major source of morbidity and expense, with over 33 million individuals affected worldwide and over 450 000 hospitalizations annually in the United States. Catheter ablation for AF is a class I indication for patients with symptomatic AF. The ability to predict postablation recurrence would have an enormous impact on both patient outcomes and cost to the health care system. Methods:Our study was an observational, single-center retrospective study to evaluate the utility of the CAAP-AF risk scoring system in predicting recurrence of AF following second-generation balloon cryoablation for AF.Results: There were a total of 235 patients. From the initial cohort, 30.2% (71) had a recurrence of AF within 1 year of the cryoablation procedure. There was a statistically significant increase in mean age, left atrial diameter, left atrial volume index, CHADS 2 , CHADS 2 -VASc, and number of antiarrhythmics failed in the group that had recurrence of AF. There was also a statistically significant increase in the CAAP-AF score in patients who had recurrence of AF.

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Clinical scores for outcomes of rhythm control or arrhythmia progression in patients with atrial fibrillation: a systematic review

Cited by 72 publications

References 76 publications

Patient characteristics as predictors of recurrence of atrial fibrillation following cryoballoon ablation

Patient characteristics as predictors of recurrence of atrial fibrillation following cryoballoon ablation

Inflammation and the risk of atrial high-rate episodes (AHREs) in patients with cardiac implantable electronic devices

Stratifying risk of recurrence of atrial fibrillation following balloon cryoablation using the CAAP‐AF risk scoring system

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