CHA2DS2-VASc Score as a Predictor of New-Onset Atrial Fibrillation After Catheter Ablation of Typical Atrial Flutter.

Fei Liu,Khalid Bin Waleed,Lianjun Gao,Yuanjun Sun,Xiaomeng Yin,Yajuan Lin,Yunlong Xia,Andrew Luhanga,Zechang Xin,Gary Tse

doi:10.3389/fphys.2020.00558

Abstract

PurposeCavotricuspid 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 CHA2DS2-VASc score to predict new-onset AF after typical AFL ablation. In this study, we assessed whether the CHA2DS2-VASc score is a useful predictor of new-onset AF after CTI ablation in typical AFL patients without a prior history of AF.MethodsThis 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.ResultsDuring 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 CHA2DS2-VASc score (hazard ratio = 1.736; 95% confidence interval = 1.370–2.201; P < 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%, P < 0.001).ConclusionThe CHA2DS2-VASc score is a useful tool for the prediction of new-onset AF after ablation of typical AFL. Patients with CHA2DS2-VASc score ≥3 are more likely to develop new-onset AF and should be monitored more closely.

Highlights

Cavotricuspid isthmus (CTI) ablation by radiofrequency is considered as the first-line therapy, and its reported success rate exceeds 90% for rhythm control in typical atrial flutter (AFL; Spector et al, 2009)
Many studies indicated that most components of CHA2DS2-VASc score are associated with cardiac remodeling, and a higher score correlated with a greater degree of cardiac structural and electrical remodeling (Park et al, 2011; Kornej et al, 2014; Ribo et al, 2015; Wang et al, 2016)
We hypothesized that patients with a higher CHA2DS2-VASc score might be associated with postablation new-onset atrial fibrillation (AF) in typical AFL patients

Summary

Introduction

Cavotricuspid isthmus (CTI) ablation by radiofrequency is considered as the first-line therapy, and its reported success rate exceeds 90% for rhythm control in typical atrial flutter (AFL; Spector et al, 2009). The mechanisms responsible for the development of postablation new-onset AF are still unclear in AFL patients. Chen et al (2015) investigated HATCH score and purposed an association with an incident of new-onset AF after typical AFL ablation. CHA2DS2-VASc is a more commonly used and clinical scoring system than HATCH, and its use for predicting new-onset AF after AFL ablation has not been explored. We hypothesized that patients with a higher CHA2DS2-VASc score might be associated with postablation new-onset AF in typical AFL patients. This study was carried out to assess the usefulness of the CHA2DS2-VASc score as a predictor of postablation new-onset AF in AFL patients without a prior history of AF

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