Key result
Novel VAT-DHF score predicts post-ablation AF recurrence with an AUC of ~0.87, outperforming standard scores.
Why the study?
Most existing scores for predicting success after catheter ablation for atrial fibrillation have not been prospectively validated, warranting research into optimal predictive formulae.
Cohort (n=263)
No
The novel VAT-DHF score, incorporating left atrial volume, AF type, diabetes, height, and f-wave amplitude, accurately predicts long-term AF recurrence after catheter ablation.
Answers are grounded in this paper and cite their sources.
VAT-DHF may refine pre-ablation AF risk stratification; extends existing scores but leaves open prospective validation.
Introduction: 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. Purpose: This study aimed to identify independent predictors of AF recurrence after CA and develop a composite score. Methods: 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. Results: 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, p < 0.0001, 95% CI [0.802–0.936], while those for APPLE and CHA2DS2-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% (p < 0.0001), respectively. Conclusions: 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.
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Năstasă et al. (2023) conducted a cohort in Atrial Fibrillation (n=263). VAT-DHF score vs. APPLE and CHA2DS2-VASc scores was evaluated on Prediction of atrial fibrillation recurrence (AUC) (AUC 0.869, 95% CI 0.802-0.936, p=<0.0001). The novel VAT-DHF score strongly predicted atrial fibrillation recurrence after catheter ablation with an AUC of 0.869, outperforming the APPLE and CHA2DS2-VASc scores.
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