Renal Dysfunction, Stroke Risk Scores (CHADS
 2
 , CHA
 2
 DS
 2
 -VASc, and R
 2
 CHADS
 2
 ), and the Risk of Thromboembolic Events After Catheter Ablation of Atrial Fibrillation

Kornej, Jelena; Hindricks, Gerhard; Kosiuk, Jędrzej; Arya, Arash; Sommer, Philipp; Husser, Daniela; Rolf, Sascha; Richter, Sergio; Piorkowski, Christopher; Gaspar, Thomas; Lip, Gregory Y. H.; Bollmann, Andreas

doi:10.1161/circep.113.000869

Cited by 48 publications

(20 citation statements)

References 34 publications

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“…Therefore, it seems that the CHA 2 DS 2 -VASc scoring system is more sensitive (than CHADS 2 ) for assessment of thromboembolic risk after catheter ablation of AF. Recently, another study confirmed these results [157]. During the 18-month follow-up after the procedure the prevalence of thromboembolic events was 0.72%.…”

Section: Thromboembolic Complications Preprocedural Thrombosis Tranmentioning

confidence: 66%

“…The risk was only 0.13% with a CHA 2 DS 2 -VASc score of 0-1 and 0.71% with a CHA 2 DS 2 -VASc score of >2. In addition, it seems that the CHA 2 DS 2 -VASc score has the best predictive value in patients with AF recurrence after catheter ablation [157].…”

Section: Thromboembolic Complications Preprocedural Thrombosis Tranmentioning

confidence: 98%

“…As already mentioned, several recent studies suggested potential value of CHA 2 DS 2 -VASc score in further stratification of so called "low risk" patients (based on a low CHADS 2 score of 0-1) after catheter ablation of AF. Thus, despite low CHADS 2 score, in patients with a CHA 2 DS 2 -VASc score of ≥2 and/or recurrence of AF, long term anticoagulation after the procedure should be considered [156,157].…”

Section: Thromboembolic Complications Preprocedural Thrombosis Tranmentioning

confidence: 99%

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Catheter Ablation of Lone Atrial Fibrillation

Mujović

Marinković²,

Potpara³

et al. 2014

CPD

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Atrial fibrillation is the most common sustained arrhythmia in clinical practice, associated with increased mortality, risk of stroke and heart failure, as well as the reduction of the quality of life. Atrial fibrillation may be encountered in young otherwise healthy individuals, due to the isolated electrophysiological disorder limited mostly to the pulmonary veins and posterior left atrial wall, or associated with the presence of advanced underlying heart disease and numerous cardiac and non-cardiac comorbidities with significant structural remodeling of the atrial myocardium. Due to limited efficacy and serious side effects of antiarrhythmic drugs, catheter ablation of atrial fibrillation, based on the pulmonary vein isolation for paroxysmal atrial fibrillation and adjunctive substrate modification for persistent atrial fibrillation, has emerged as an attractive and promissing alternative therapeutic option for selected patients with atrial fibrillation. In this review article, we discuss the electrophysiological left atrial abnormalities underlying lone atrial fibrillation and the role of pulmonary veins in pathophysiology of arrhythmia, and we summarize results of the studies on the long term outcome of catheter ablation of atrial fibrillation, as well as the studies on comparison of antiarrhythmic drugs with catheter ablation for treatment of atrial fibrillation. In addition, we present available data that provide better understanding of mechanisms, diagnosis, prevention and treatment of specific procedure-related complications and discuss current periprocedural anticoagulation strategies and their impact on the thromboembolic risk reduction.

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Section: Thromboembolic Complications Preprocedural Thrombosis Tranmentioning

confidence: 66%

Section: Thromboembolic Complications Preprocedural Thrombosis Tranmentioning

confidence: 98%

Section: Thromboembolic Complications Preprocedural Thrombosis Tranmentioning

confidence: 99%

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Catheter Ablation of Lone Atrial Fibrillation

Mujović

Marinković²,

Potpara³

et al. 2014

CPD

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“…9,10 The activation of the clotting system is another critical issue, which is related to the duration of the RF procedure and concurs to asymptomatic cerebral emboli. 8,11 In this issue of Circulation, Stazzi et al 12 address the question as to whether platelet activation is also implicated in the prothrombotic state occurring after RF ablation and if remote ischemic preconditioning (IPC) is able to prevent it.…”

Section: Article See P 11mentioning

confidence: 99%

Platelet Activation After Radiofrequency Ablation in Atrial Fibrillation

Violi

Pignatelli

2014

Circulation

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“…Since many of the clinical factors included in the most common stroke risk prediction instruments 2, 3 , CHADS2, and CHA2DS2-VASc, are also associated with development of AF 4, 5 , several studies have examined the predictive capacities of these same instruments for recurrent AF after PVI. Unfortunately, although CHADS2 and CHA2DS2-VASc show excellent performance for stroke prediction, they demonstrate only modest discriminative ability with respect to identifying individuals at risk for AF recurrence after PVI 6-9 .…”

Section: Introductionmentioning

confidence: 99%

Addition of B-Type Natriuretic Peptide to Existing Clinical Risk Scores Enhances Identification of Patients at Risk for Atrial Fibrillation Recurrence After Pulmonary Vein Isolation

Shaikh

Esa

Martin‐Doyle

et al. 2015

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine

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Introduction Predicting which patients will be free from atrial fibrillation (AF) after pulmonary vein isolation (PVI) remains challenging. Clinical risk prediction scores show modest ability to identify patients at risk for AF recurrence after PVI. B-type natriuretic peptide (BNP) is associated with risk for incident and recurrent AF, but is not currently included in existing AF risk scores. We sought to evaluate the incremental benefit of adding pre-operative BNP to existing risk scores for predicting AF recurrence during the 6 months after PVI. Methods and Results 161 patients with paroxysmal or persistent AF underwent an index PVI procedure between 2010 and 2013; 77 patients (48%) had late AF recurrence after PVI (>3 months post-PVI) over the 6-month follow-up period. A BNP ≥100 pg/dL (p = 0.01) and AF recurrence within 3-months post-PVI (p<0.001) were associated with late AF recurrence in multivariate analyses. Addition of BNP to existing clinical risk scores significantly improved the areas under the curve (AUC) for each score, with an integrated discrimination improvement (IDI) of 0.08 (p=0.001); and a net reclassification improvement (NRI) of 60% (p=0.001) for all risk scores. Conclusions Circulating BNP levels are independently associated with late AF recurrence after PVI. Inclusion of BNP significantly improves the discriminative ability of CHADS2, CHA2DS2-VASc, R2CHADS2, and the HATCH score in predicting clinically significant, late AF recurrence after PVI and should be incorporated in decision making algorithms for management of AF. B-R2CHADS2 is the best score model for prediction of late AF recurrence.

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Renal Dysfunction, Stroke Risk Scores (CHADS ₂ , CHA ₂ DS ₂ -VASc, and R ₂ CHADS ₂ ), and the Risk of Thromboembolic Events After Catheter Ablation of Atrial Fibrillation

Cited by 48 publications

References 34 publications

Catheter Ablation of Lone Atrial Fibrillation

Catheter Ablation of Lone Atrial Fibrillation

Platelet Activation After Radiofrequency Ablation in Atrial Fibrillation

Addition of B-Type Natriuretic Peptide to Existing Clinical Risk Scores Enhances Identification of Patients at Risk for Atrial Fibrillation Recurrence After Pulmonary Vein Isolation

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Renal Dysfunction, Stroke Risk Scores (CHADS 2 , CHA 2 DS 2 -VASc, and R 2 CHADS 2 ), and the Risk of Thromboembolic Events After Catheter Ablation of Atrial Fibrillation

Cited by 48 publications

References 34 publications

Catheter Ablation of Lone Atrial Fibrillation

Catheter Ablation of Lone Atrial Fibrillation

Platelet Activation After Radiofrequency Ablation in Atrial Fibrillation

Addition of B-Type Natriuretic Peptide to Existing Clinical Risk Scores Enhances Identification of Patients at Risk for Atrial Fibrillation Recurrence After Pulmonary Vein Isolation

Contact Info

Product

Resources

About

Renal Dysfunction, Stroke Risk Scores (CHADS ₂ , CHA ₂ DS ₂ -VASc, and R ₂ CHADS ₂ ), and the Risk of Thromboembolic Events After Catheter Ablation of Atrial Fibrillation