A new scoring system: PATCH score. Its clinical use and comparison with HATCH and CHADS-VASc scores in predicting arrhythmia recurrence after cryoballoon ablation of paroxysmal atrial fibrillation.

BACKGROUND

Several clinical risk factors and scoring systems have been proposed to predict arrhythmia recurrence after atrial fibrillation (AF) ablation. We sought to determine the ability of a new score to predict atrial arrhythmia recurrence after cryoballoon (CB) ablation of AF and whether the new score shows superior efficiency compared to previously offered scores.

METHODS

A total of 419 patients with paroxysmal AF who underwent their first CB ablation were included. Baseline clinical variables were analyzed, and independent predictors of recurrence at 12 months were used to develop the PATCH score. The predictive capability of the new score was calculated and compared with the currently available risk scores.

RESULTS

Chronic obstructive pulmonary disease, left atrial dilatation, transient ischemic attack or stroke, congestive heart failure, and hypertension were independent predictors of recurrence. The PATCH score which was developed from these variables had a better clinical predictive capability of arrhythmia recurrence compared to HATCH and CHADS-VASc scores. With increasing PATCH score and score severity (low, score of 0; moderate, score of 1-2; and high, score of ≥ 3), the proportion of patients with recurrence was increased from 7% (score = 0, severity = low) to 59% (score ≥ 3, severity = high).

CONCLUSIONS

The PATCH score may help to identify patients who are likely benefited most from CB ablation of paroxysmal AF and who should be monitored more closely for arrhythmia recurrence at 12 months.