Key result
APCEL risk score predicts late AF recurrence post-ablation with an AUC of ~0.80.
Why the study?
Existing AF catheter ablation recurrence risk scores showed significant differences in follow-up duration, pre-procedural AF duration, ablation energy sources, and LA diameter cut-offs, prompting the development of a new recurrence risk score for prolonged follow-up.
Can the APCEL risk score predict late recurrence of atrial fibrillation after catheter ablation?
Cohort (n=206)
Can the APCEL risk score predict late recurrence of atrial fibrillation after catheter ablation?
Effect estimate: AUC 0.798 at 36 months (95% CI 0.726-0.868)
The newly developed APCEL score effectively identifies patients at high risk of late recurrence during extended follow-up after AF ablation.
May aid post-ablation risk stratification in observational cohorts; leaves open external validation and impact on outcomes.
Background In studies where risk scores used to determine the risk of late recurrence after atrial fibrillation (AF) catheter ablation were defined, significant differences were observed in terms of parameters such as post‐procedural follow‐up time, pre‐procedural AF time, energy sources used for ablation, and cut‐off values of left atrium (LA) diameter. Considering all these factors, we aimed to develop a new recurrence risk score for prolonged follow‐up after AF ablation. Methods The study included 206 patients who underwent index AF catheter ablation for paroxysmal or persistent AF. Independent predictors of late recurrence were identified at a median follow‐up of 40 months (range: 21–57), and a risk score was created. The predictive ability of this score for late recurrence was compared with that of other risk scores. Results Independent predictors of late recurrence development included pre‐ablation AF duration >19 months, persistent AF, early recurrence, chronic obstructive pulmonary disease, and LA volume index >31 mL/m 2 . The APCEL risk score, derived from these factors (Early recurrence: 3 points, AF duration >19 months: 2 points, others: 1 point), demonstrated good predictive performance for late recurrence at 6th [AUC: 0.940, 95% CI: 0.896–0.983], 12th [AUC: 0.865, 95% CI: 0.796–0.932], 24th [AUC: 0.814, 95% CI: 0.743–0.885], and 36th months [AUC: 0.798, 95% CI: 0.726–0.868]. Conclusions The APCEL score, calculated at the end of the blanking period for patients who underwent AF ablation, can effectively identify those at high risk of late recurrence during extended follow‐up.
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Ulus et al. (2025) conducted a cohort in Atrial fibrillation (n=206). APCEL risk score was evaluated on Late recurrence of atrial fibrillation (AUC 0.798 at 36 months, 95% CI 0.726-0.868). The APCEL risk score effectively predicted late recurrence of atrial fibrillation after catheter ablation, demonstrating an AUC of 0.798 (95% CI 0.726-0.868) at 36 months follow-up.
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