Jin Moo Nyun, Song Changho, Kim Tae Hoon, Uhm Jae Sun, Pak Hui Nam, Lee Moon Hyoung, Joung Boyoung
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2018 Mar;59(2):236-242. doi: 10.3349/ymj.2018.59.2.236.
Despite undergoing successful catheter ablation of typical atrial flutter (AFL), patients remain at increased risk for ischemic stroke. However, data on risk prediction tools for the development of stroke after AFL ablation are lacking. This study investigates whether CHA₂DS₂-VASc score is useful for predicting ischemic stroke after successful ablation of typical AFL.
A total of 293 patients (236 men, mean age 56.1±13.5 years) who underwent successful radiofrequency catheter ablation for typical AFL were included in this study. The clinical end point was occurrence of ischemic stroke during follow-up after AFL ablation.
During the follow-up period (60.8±45.9 months), ischemic stroke occurred in 18 (6%) patients at a median of 34 months (interquartile range, 13-65 months). CHA₂DS₂-VASc score [hazard ratio 2.104; 95% confidence interval (CI), 1.624-2.726; p<0.001] was an independent predictor for the occurrence of stroke after AFL ablation. The area under the receiver operating characteristic curve for CHA₂DS₂-VASc score was 0.798 (95% CI, 0.691-0.904). The CHA₂DS₂-VASc score could be used to stratify patients into two groups with different incidences of ischemic stroke (1.6% vs. 14.4%, p<0.001) at a cutoff value of 2.
CHA₂DS₂-VASc score is useful in a prediction model for the risk of stroke after catheter ablation of typical AFL.
尽管典型心房扑动（AFL）患者成功接受了导管消融治疗，但仍面临缺血性卒中风险增加的问题。然而，目前缺乏关于AFL消融术后卒中发生风险预测工具的数据。本研究旨在探讨CHA₂DS₂-VASc评分是否有助于预测典型AFL成功消融术后的缺血性卒中。
本研究纳入了293例成功接受典型AFL射频导管消融治疗的患者（236例男性，平均年龄56.1±13.5岁）。临床终点为AFL消融术后随访期间缺血性卒中的发生情况。
在随访期（60.8±45.9个月）内，18例（6%）患者发生缺血性卒中，中位时间为34个月（四分位间距，13 - 65个月）。CHA₂DS₂-VASc评分[风险比2.104；95%置信区间（CI），1.624 - 2.726；p<0.001]是AFL消融术后卒中发生的独立预测因素。CHA₂DS₂-VASc评分的受试者工作特征曲线下面积为0.798（95%CI，0.691 - 0.904）。CHA₂DS₂-VASc评分可用于将患者分为两组，截断值为2时，缺血性卒中发生率不同（1.6%对14.4%，p<0.001）。
CHA₂DS₂-VASc评分在典型AFL导管消融术后卒中风险预测模型中具有应用价值。
