Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
National Center for Trauma Medicine, Key Laboratory of Trauma and Neural Regeneration, Trauma Center, Peking University People's Hospital, Beijing, China.
Ann Palliat Med. 2021 Apr;10(4):4299-4307. doi: 10.21037/apm-21-437. Epub 2021 Apr 1.
Several scores were available for predicting atrial fibrillation (AF) recurrence post radiofrequency ablation. However, the role of different scores predicting AF recurrence after ablation in patients with concurrent AF and pulmonary diseases (PDs) remained obscure. Herein, we aimed to investigate their predicting values and differences in patients with concurrent AF and PDs.
From January 2008 to April 2015, 304 patients with concurrent AF and PDs treated with catheter ablation were divided into 2 groups according to whether they experienced AF recurrence in our centers. Factors related with AF recurrence were explored using Cox regression and scores predicting recurrent AF were compared in these patients using ROC curves.
During a median of 6-month of follow-up, factors correlating with late AF recurrence included heart failure (HF) history [hazard ratio (HR): 2.79; 95% confidence interval (CI): 1.49-5.22, P=0.001], current smoking (1.73; 1.13-2.68, P=0.01) and early AF recurrence (3.85; 95% CI: 2.62-5.66, P<0.001) according to univariate Cox regression analysis. When analyzed using multivariate Cox model, HF history (2.21; 1.12-4.37, P=0.02), hypertension history (1.54; 1.02-2.33, P=0.04) and early AF recurrence (3.90; 2.60-5.85, P<0.001) were related to late AF recurrence. The BASE-AF2 score had higher c-index than the MB-LATER, APPLE, CHADS2, CHA2DS2-VASc, CAAP-AF and HATCH scores when compared using ROC curves analysis (all P<0.05). The optimal point for predicting AF recurrence of the BASE-AF2 score in the ROC analysis was 1 point with sensitivity of 69.03% and specificity of 60.21%.
The predicting AF recurrence value of BASE-AF2 score was superior to MB-LATER, APPLE, CHADS2, CHA2DS2-VASc, CAAP-AF and HATCH scores in patients with concurrent AF and PDs, which can be an effective and helpful score for making AF treatment decisions.
有几种评分可用于预测射频消融术后心房颤动（AF）的复发。然而，在患有 AF 和肺部疾病（PDs）的患者中，不同评分预测消融后 AF 复发的作用仍不清楚。在此，我们旨在研究它们在伴有 AF 和 PDs 的患者中的预测价值和差异。
2008 年 1 月至 2015 年 4 月，304 例患有并发 AF 和 PDs 并接受导管消融治疗的患者根据其是否在我院中心复发 AF 而分为两组。使用 Cox 回归探讨与 AF 复发相关的因素，并使用 ROC 曲线比较这些患者中预测 AF 复发的评分。
在中位数为 6 个月的随访期间，根据单因素 Cox 回归分析，与晚期 AF 复发相关的因素包括心力衰竭（HF）病史[风险比（HR）：2.79；95%置信区间（CI）：1.49-5.22，P=0.001]、当前吸烟（1.73；1.13-2.68，P=0.01）和早期 AF 复发（3.85；95%CI：2.62-5.66，P<0.001）。当使用多因素 Cox 模型分析时，HF 病史（2.21；1.12-4.37，P=0.02）、高血压病史（1.54；1.02-2.33，P=0.04）和早期 AF 复发（3.90；2.60-5.85，P<0.001）与晚期 AF 复发相关。与 MB-LATER、APPLE、CHADS2、CHA2DS2-VASc、CAAP-AF 和 HATCH 评分相比，BASE-AF2 评分在 ROC 曲线分析中具有更高的 C 指数（均 P<0.05）。在 ROC 分析中，预测 BASE-AF2 评分 AF 复发的最佳切点为 1 分，敏感性为 69.03%，特异性为 60.21%。
在患有 AF 和 PDs 的患者中，BASE-AF2 评分预测 AF 复发的价值优于 MB-LATER、APPLE、CHADS2、CHA2DS2-VASc、CAAP-AF 和 HATCH 评分，可作为制定 AF 治疗决策的有效且有帮助的评分。
