Role of CHA2DS2-VASc score in predicting atrial fibrillation recurrence in patients undergoing pulmonary vein isolation with cryoballoon ablation

Rordorf, Roberto; Iacopino, Saverio; Verlato, Roberto; Arena, Giuseppe; Tondo, Claudio; Molon, Giulio; Manfrin, Massimiliano; Rovaris, Giovanni; Perego, Giovanni Battista; Sciarra, Luigi; Mantica, Massimo; Sacchi, Riccardo; Pieragnoli, Paolo

doi:10.1007/s10840-022-01430-7

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…Previous studies have evaluated clinical predictors for arrhythmia recurrence after PVI, both in isolation and in the aggregation of scores such as the CHA 2 DS 2 -VASc score or the APPLE score. 18–23 Studies have also shown association between diabetes, hypertension, renal disease, heart failure, and obesity with LA sizes and that increased LA sizes predict recurrence after PVI. 24–30 Most of these factors are linked to advanced atrial cardiomyopathy.…”

Section: Discussionmentioning

confidence: 99%

Impact of atrial fibrillation phenotype and left atrial volume on outcome after pulmonary vein isolation

Chollet,

Iqbal,

Wittmer

et al. 2024

Europace

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Aims Pulmonary vein isolation (PVI) is increasingly performed in patients with atrial fibrillation (AF). Both AF phenotype and left atrial (LA) volume have been shown to influence ablation outcome. The inter-relationship of the two is incompletely understood. We aimed to investigate the impact of AF phenotype vs. LA volume on outcome after PVI. Methods and results In a retrospective analysis of a prospective registry of patients undergoing a first PVI, the association of AF phenotype and LA volume index (LAVI) was assessed as well as their impact on AF recurrence during follow-up. Overall, 476 patients were enrolled (median age 63 years, 29% females, 65.8% paroxysmal AF). Obesity, hypertension, chronic kidney disease, and heart failure were all significantly more frequent in persistent AF. After 1 year, single-procedure, freedom from arrhythmia recurrence was 61.5%. Patients with paroxysmal AF had better outcomes compared with patients with persistent AF (65.6 vs. 52.7%, P = 0.003), as had patients with no/mild vs. moderate/severe LA dilation (LAVI <42 mL/m2 67.1% vs. LAVI ≥42 mL/m2 53%, P < 0.001). The combination of both parameters refined prediction of 1-year recurrence (P < 0.001). After adjustment for additional clinical risk factors in multivariable Cox proportional hazard analysis, both AF phenotype and LAVI ≥42 mL/m2 contributed significantly towards the prediction of 1-year recurrence. Conclusion Atrial fibrillation phenotype and LA volume are independent predictors of outcome after PVI. Persistent AF with no/mild LA dilation has a similar risk of recurrence as paroxysmal AF with a moderate/severe LA dilation and should be given similar priority for ablation.

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Section: Discussionmentioning

confidence: 99%

Impact of atrial fibrillation phenotype and left atrial volume on outcome after pulmonary vein isolation

Chollet,

Iqbal,

Wittmer

et al. 2024

Europace

View full text Add to dashboard Cite

show abstract

“…The area under the curve (AUC) was used as the predictive value indicator of the tested new score. The predictive performance of the new scoring system was also compared to the existing scoring systems, such as 0‐1‐2 PL, 23 APPLE, 24 CAAP‐AF, 25 CHADS2, 26 CHA2‐DS2‐VASc, 27 DR‐FLASH, 28 HATCH, 29 and PAT2C2H scores 30 . AF recurrence‐free survival curves for patient subgroups were generated and compared using the Kaplan‐Meier method and log‐rank test, respectively.…”

Section: Methodsmentioning

confidence: 99%

Novel scoring system derived from meta‐analysis and validated in cohort population for predicting 1‐year atrial fibrillation recurrence after cryoballoon catheter ablation: The HeLPS‐Cryo score

Waranugraha,

Hsu,

Lin

et al. 2024

Pacing Clinical Electrophis

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BackgroundAtrial fibrillation (AF) recurrence rates in 1 year after cryoballoon ablation catheter (CBCA) are still high. We purposed to identify strong predictors for AF recurrence after the successful CBCA procedure and develop a new scoring system based only on pre‐procedural parameters.MethodsIn the derivation phase, a systematic review and meta‐analysis identified the strong predictors of AF recurrence after the CBCA. The pooled hazard ratio (HR) was used to create the new scoring system. The second phase validated the new scoring system in the cohort population.ResultsA meta‐analysis including 29 cohort studies with 16196 participants confirmed that persistent AF, stroke, heart failure, and left atrial diameter (LAD) >40 mm were powerful predictors for AF recurrence after the CBCA procedure. The HeLPS‐Cryo (heart failure [1], left atrial dilatation [1], persistent AF [2], and stroke [2]) was developed based on those pre‐procedural predictors. It was validated in 140 patients receiving CBCA procedures and revealed excellent predictive performance for 1‐year AF recurrence (AUC = 0.8877; 95% CI = 0.8208 to 0.9546). The HeLPS‐Cryo score of ≥3 could predict 1‐year AF recurrence with sensitivity and specificity of 78.9% and 87.9%, respectively. The positive predictive value was 66.7%, and the negative predictive value was 93.1%.ConclusionThe HeLPS‐Cryo score can help the physician estimate the probability of 1‐year AF recurrence after the successful CBCA procedure. Patients with HeLPS‐Cryo score <3 are good candidates for the CBCA procedure.

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Factors predicting the recurrence of atrial fibrillation after catheter ablation: A review

Mo,

Wang,

Zhang

et al. 2024

Heliyon

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Role of CHA2DS2-VASc score in predicting atrial fibrillation recurrence in patients undergoing pulmonary vein isolation with cryoballoon ablation

Cited by 3 publications

References 22 publications

Impact of atrial fibrillation phenotype and left atrial volume on outcome after pulmonary vein isolation

Impact of atrial fibrillation phenotype and left atrial volume on outcome after pulmonary vein isolation

Novel scoring system derived from meta‐analysis and validated in cohort population for predicting 1‐year atrial fibrillation recurrence after cryoballoon catheter ablation: The HeLPS‐Cryo score

Factors predicting the recurrence of atrial fibrillation after catheter ablation: A review

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