CHADS2 score predicts time interval free of atrial fibrillation in patients with symptomatic paroxysmal atrial fibrillation

Ilic, Ljubomir M.; Goldenberg, Edward

doi:10.1016/j.ijcard.2010.05.063

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…14 CHADS2 score was the only statistically significant determinant of AF-free interval in patients with PAF. 15 Recently, a combined risk score, which allowed for pre-ablation estimation of probability of AF recurrence after both single and repeated procedure, was presented. 16 We called it ALARMEc (AF type, Left Atrium size, Renal insufficiency, MEtabolic syndrome, cardiomyopathy) risk score.…”

Section: Combined Predictors Of Outcomementioning

confidence: 99%

Repeated Catheter Ablation of Atrial Fibrillation

Wójcik

Berkowitsch

Greiß

et al. 2013

Circ J

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Section: Combined Predictors Of Outcomementioning

confidence: 99%

Repeated Catheter Ablation of Atrial Fibrillation

Wójcik

Berkowitsch

Greiß

et al. 2013

Circ J

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“…However, despite recent data on reduced recurrence after RFCA, the recurrence of atrial arrhythmia remains challenging. Several studies have shown that a history of diabetes mellitus, hypertension, impaired renal function, increasing CHA 2 DS 2 -VASc score, and long duration of AF significantly increase the risk of AF recurrence ( 13 , 14 ). Also, among echocardiographic risk factors, enlarged LA diameter, decreased ejection fraction, and increased E/e′ are known to be associated with increased late recurrence ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of pulmonary artery pressure on recurrence after catheter ablation in patients with atrial fibrillation

Choi,

Jeong

et al. 2023

Front. Cardiovasc. Med.

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BackgroundThe pulmonary veins play a major role in the pathogenesis of atrial fibrillation (AF) and may be affected by cardiac remodeling due to pulmonary vascular dysfunction. It remains to be determined whether pulmonary artery pressure (PAP) is associated with the recurrence of AF after radiofrequency catheter ablation (RFCA).MethodsConsecutive patients with paroxysmal and persistent AF who underwent RFCA, including wide circumferential pulmonary vein isolation, were analyzed. Systolic PAP was measured using transthoracic echocardiography, and clinical outcomes were compared between patients with PAP <35 mmHg and those with PAP ≥35 mmHg.ResultsAmong 2,379 patients (mean age 56.7 ± 10.6 years, 77% men), 1,893 (79.6%) had PAP <35 mmHg and 486 (20.4%) had PAP ≥35 mmHg. During the median follow-up of 25.4 months, in patients with paroxysmal AF (n = 1,294), the recurrence rate was significantly greater in the PAP ≥35 mmHg group than in the PAP <35 mmHg group (35.1% vs. 23.8%, log-rank p = 0.008). However, in patients with persistent AF (n = 1,085), the recurrence rate was not significantly different between the two groups (52.2% vs. 49.7%, log-rank p = 0.409). Multivariate analysis using Cox regression showed that PAP ≥35 mmHg was significantly associated with clinical recurrence (hazard ratio 1.19, 95% confidence interval 1.02–1.40, p = 0.027).ConclusionThis study showed that a higher PAP was associated with an increased risk of recurrence after RFCA in patients with paroxysmal AF, suggesting a mechanism by which a pulmonary vascular pathology may cause impairment of the pulmonary veins and remodeling of the left atrium.

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Estimated pulmonary capillary wedge pressure assessed by speckle tracking echocardiography predicts successful ablation in paroxysmal atrial fibrillation

Kawasaki

Tanaka

Miyake

et al. 2015

Cardiovasc Ultrasound

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BackgroundAtrial fibrillation (AF) is associated with left atrial (LA) remodeling caused by pressure and/or volume (LAV) overload. Increased pulmonary capillary wedge pressure (PCWP) represents LA pressure overload. We recently reported that pulmonary capillary wedge pressure (ePCWP) can be estimated by the kinetics-tracking (KT) index that combines LA function and volume using speckle tracking echocardiography (STE), and has a strong correlation with PCWP measured by right heart catheterization (r = 0.92). Therefore, we hypothesized that ePCWP is the best echocardiographic predictor of successful AF ablation.MethodsWe enrolled 137 patients with paroxysmal AF (age: 61 ± 10 years) who underwent pulmonary vein isolation. We measured LAV index, LA emptying function (EF) and LA stiffness during sinus rhythm before ablation using STE. PCWP was noninvasively estimated by STE as we previously reported. Parameters were compared between a group with AF recurrence (n = 30, age: 59 ± 11 years) and a group with successful ablation (sinus rhythm maintained for >1 year) (n = 107, age 61 ± 11 years).ResultsThe ePCWP was correlated with PCWP measured by right heart catheterization (r = 0.76, p < 0.01). Compared with the non-recurrence group (n = 107, age: 61 ± 11), the AF recurrence group had significantly increased ePCWP (10.6 ± 3.5 vs 14.6 ± 2.9 mmHg, p < 0.01), minimum LAV index (29 ± 12 ml/m2 vs 37 ± 14 ml/m2, p < 0.01) and LA stiffness (0.47 ± 0.33 vs 0.83 ± 0.59, p < 0.01), but lower total LA EF (44 ± 11 % vs 39 ± 13 %, p < 0.01) before ablation. In multivariate logistic regression analysis, ePCWP was the most significant independent predictor of successful ablation. Using 13 mmHg of PCWP as the optimal cutoff value, the sensitivity and specificity for successful ablation were 73 and 77 % (area under the curve = 0.81), respectively.ConclusionThe ePCWP that is measured by the combination of LA function and volume before ablation was a better predictor of the successful ablation compared with LA function and volume separately. The ePCWP estimated by STE is useful to predict the successful ablation in paroxysmal AF, and could be useful to improve candidate selection for AF ablation.

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CHADS2 score predicts time interval free of atrial fibrillation in patients with symptomatic paroxysmal atrial fibrillation

Cited by 3 publications

References 7 publications

Repeated Catheter Ablation of Atrial Fibrillation

Repeated Catheter Ablation of Atrial Fibrillation

Impact of pulmonary artery pressure on recurrence after catheter ablation in patients with atrial fibrillation

Estimated pulmonary capillary wedge pressure assessed by speckle tracking echocardiography predicts successful ablation in paroxysmal atrial fibrillation

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