Liu Fei, Xin Zechang, Bin Waleed Khalid, Lin Yajuan, Tse Gary, Luhanga Andrew, Sun Yuanjun, Gao Lianjun, Yin Xiaomeng, Xia Yunlong
Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
Faculty of Medicine, Dalian Medical University, Dalian, China.
Front Physiol. 2020 Jun 10;11:558. doi: 10.3389/fphys.2020.00558. eCollection 2020.
Cavotricuspid isthmus (CTI) ablation is an effective procedure for typical atrial flutter (AFL), but patients remain at an elevated risk for developing new atrial fibrillation (AF). Currently, there are limited data on the utility of CHADS-VASc score to predict new-onset AF after typical AFL ablation. In this study, we assessed whether the CHADS-VASc score is a useful predictor of new-onset AF after CTI ablation in typical AFL patients without a prior history of AF.
This was a retrospective study of 103 typical AFL patients with no prior history of AF, who underwent successful CTI ablation. The endpoint was occurrence of new-onset AF during follow-up.
During a mean follow-up period of 24.6 ± 16.9 months, at least one episode of AF occurred in 33 (32%) patients. Multivariate Cox regression analysis revealed that CHADS-VASc score (hazard ratio = 1.736; 95% confidence interval = 1.370-2.201; < 0.001) was significantly associated with postablation new-onset AF (area under the curve = 0.797). A cutoff value of three stratified these patients into two groups with different incidences of postablation new-onset AF (67.9 vs. 18.7%, < 0.001).
The CHADS-VASc score is a useful tool for the prediction of new-onset AF after ablation of typical AFL. Patients with CHADS-VASc score ≥3 are more likely to develop new-onset AF and should be monitored more closely.
三尖瓣峡部（CTI）消融术是治疗典型心房扑动（AFL）的有效方法，但患者发生新发心房颤动（AF）的风险仍然较高。目前，关于CHADS-VASc评分预测典型AFL消融术后新发AF效用的数据有限。在本研究中，我们评估了CHADS-VASc评分是否是无AF病史的典型AFL患者CTI消融术后新发AF的有用预测指标。
这是一项对103例无AF病史且成功接受CTI消融术的典型AFL患者的回顾性研究。终点是随访期间新发AF的发生情况。
在平均24.6±16.9个月的随访期内，33例（32%）患者至少发生了一次AF。多因素Cox回归分析显示，CHADS-VASc评分（风险比=1.736；95%置信区间=1.370-2.201；P<0.001）与消融术后新发AF显著相关（曲线下面积=0.797）。CHADS-VASc评分为3分的临界值将这些患者分为两组，两组消融术后新发AF的发生率不同（67.9%对18.7%，P<0.001）。
CHADS-VASc评分是预测典型AFL消融术后新发AF的有用工具。CHADS-VASc评分≥3分的患者更有可能发生新发AF，应进行更密切的监测。
