Scoring systems in the prediction of atrial fibrillation recurrence after surgical ablation

Abstract

Introduction: More than every third patient experiences recurrent atrial fibrillation after surgical pulmonary vein ablation. However, it remains challenging to predict who will and who will not experience this event. Scoring systems containing baseline risk factors have been proposed as a complementary tool to identify patients at higher risk of experiencing atrial fibrillation recurrence. Therefore, the aim of this study was to assess the value of the scoring systems APPLE, CHA 2 DS 2 -VASc, and CHADS 2 in predicting atrial fibrillation recurrence following surgical ablation.Methods: In a retrospective study, we identified all patients undergoing concomitant pulmonary vein ablation during cardiac surgery. APPLE-, CHA 2 DS 2 -VASc-, and CHADS 2 scores were calculated for each patient. Subsequently, the predictive value of the scoring systems on atrial fibrillation recurrence 3-12 months postablation was assessed using receiver operating characteristic curves and logistic regression analyses.Results: Receiver operating characteristic curves showed the superiority of the APPLE scoring system with an area under the curve of 0.690 compared to 0.571 for CHA 2 DS 2 -VASc and 0.569 for CHADS 2 , p = .01. Using logistic regression analyses, APPLE and CHA 2 DS 2 -VASc were predictors of atrial fibrillation recurrence between 3-and 12 months after surgical ablation (odds ratio [OR] 1.93, 95% confidence interval [CI] 1.39-2.67, p < .01 and OR 1.17, 95% CI 1.01-1.36, p = .04, respectively).Conclusions: The APPLE scoring system is superior to CHA 2 DS 2 -VASc and CHADS 2 in predicting atrial fibrillation recurrence after surgical ablation. It can be used as a complementary tool to select the right candidates for surgical ablation and identify patients who need more frequent clinical and electrocardiogram controls.

Predictive Value of Machine Learning for Recurrence of Atrial Fibrillation after Catheter Ablation: A Systematic Review and Meta-Analysis

“…Among them, one article was unavailable in full text, 6 articles were excluded for other reasons, and one article was deleted due to duplication of an identical cohort. Finally, 40 studies were included in this systematic review and meta-analysis [ 12 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. Fig.…”

“…The majority of catheter ablation procedures were performed using radiofrequency ablation or cryoablation, and the average follow-up time ranged from 4 months to 120 months. Patients from the United States were represented in 6 studies [ 12 , 17 , 18 , 19 , 20 , 21 ], Europe in 11 studies [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ], and the Asia-Pacific region in 23 studies [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. Regarding the ML algorithms, logistic regression was the most commonly used method for predicting AF recurrence after catheter ablation, accounting for 24 out of 40 studies (60%).…”