CHA₂DS₂-VASc Score in the Prediction of Ischemic Stroke in Patients after Radiofrequency Catheter Ablation of Typical Atrial Flutter.

Abstract

PurposeDespite 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.Materials and MethodsA 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.ResultsDuring 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.ConclusionCHA2DS2-VASc score is useful in a prediction model for the risk of stroke after catheter ablation of typical AFL.