Nastasă Alexandrina, Bogdan Ștefan, Iorgulescu Corneliu, Radu Andrei Dan, Craițoiu-Nirlu Luminița, Vătășescu Radu Gabriel
Cardiology Departament, Elias Universitary Emergency Hospital, 011461 Bucharest, Romania.
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
J Clin Med. 2023 Dec 22;13(1):61. doi: 10.3390/jcm13010061.
Catheter ablation (CA) for atrial fibrillation (AF) has been proven to have the highest efficacy in maintaining sinus rhythm. Several studies have proposed different scores for predicting post-procedural success, but most have not been validated in prospective cohorts. Further research is required to determine the optimal formulae.
This study aimed to identify independent predictors of AF recurrence after CA and develop a composite score.
Consecutive patients with persistent and paroxysmal AF who underwent CA were retrospectively analyzed. The independent predictors of recurrence were used to create a new predictive score.
The cohort included 263 patients with a follow-up of 37.6 ± 23.4 months. Persistent AF, f-waves < 0.1 mV, indexed left atrium volume, the presence of type 2 diabetes, and smaller height were independent predictors of recurrence and were used to create a new scoring model, VAT-DHF (V = Volume, AT = AF Type, D = Diabetes, H = Height, F = f waves). The ROC curve for this new score showed an AUC of 0.869, < 0.0001, 95% CI [0.802-0.936], while those for APPLE and CHADS-VASc showed an AUC of 0.765, 95% CI [0.637-0.893] and an AUC of 0.655, 95% CI [0.580-0.730], respectively. Patients who had a VAT-DHF score between 0 and 3.25, 3.25 and 6, and ≥6, had success rates of 95.7%, 76.3%, and 25% ( < 0.0001), respectively.
The novel VAT-DHF score is easy to calculate and may be a useful clinical tool for identifying patients with a low, intermediate, or high risk of AF recurrence after CA.
心房颤动（AF）导管消融术（CA）已被证明在维持窦性心律方面具有最高疗效。多项研究提出了不同的评分来预测术后成功率，但大多数尚未在前瞻性队列中得到验证。需要进一步研究以确定最佳公式。
本研究旨在确定CA术后房颤复发的独立预测因素并制定一个综合评分。
对连续接受CA的持续性和阵发性房颤患者进行回顾性分析。复发的独立预测因素用于创建一个新的预测评分。
该队列包括263例患者，随访时间为37.6±23.4个月。持续性房颤、f波<0.1 mV、左心房容积指数、2型糖尿病的存在以及身高较矮是复发的独立预测因素，并用于创建一个新的评分模型VAT-DHF（V=容积，AT=房颤类型，D=糖尿病，H=身高，F=f波）。这个新评分的ROC曲线显示AUC为0.869，P<0.0001，95%CI[0.802-0.936]，而APPLE和CHADS-VASc的AUC分别为0.765，95%CI[0.637-0.893]和0.655，95%CI[0.580-0.730]。VAT-DHF评分在0至3.25、3.25至6以及≥6之间的患者，成功率分别为9
