Key result
A novel risk score model using F-wave voltage, AF duration, left atrial volume index, and age predicted AF recurrence after the Cryo-Maze procedure with an AUC of 0.78 (95% CI 0.65-0.91).
Why the study?
A novel risk score model was needed for quantitative prediction of the rate of AF recurrence after the Cryo-Maze procedure in patients with persistent AF.
Can a novel risk score model predict atrial fibrillation recurrence in patients with persistent AF undergoing the Cryo-Maze procedure concomitant with other cardiac surgery?
Cohort (n=450)
No
Can a novel risk score model predict atrial fibrillation recurrence in patients with persistent AF undergoing the Cryo-Maze procedure concomitant with other cardiac surgery?
A novel risk score incorporating F-wave voltage, AF duration, left atrial volume index, and age effectively predicts AF recurrence after the Cryo-Maze procedure, aiding in patient selection.
Answers are grounded in this paper and cite their sources.
May aid Cryo-Maze selection in persistent AF; leaves open external validation before clinical adoption.
OBJECTIVES: This study aimed to develop a novel risk score model for quantitative prediction of the rate of atrial fibrillation (AF) recurrence after the Cryo-Maze procedure in patients with persistent AF. METHODS: We enrolled 450 consecutive patients who underwent the Cryo-Maze procedure for persistent AF concomitant with other cardiac procedures in our institute between 2001 and 2019. We randomly divided the cohort into two groups. We derived a model in a 'development cohort' (270 patients; 60%) and validated it in a 'test cohort' (180 patients; 40%) by receiver operating characteristic curve analysis. RESULTS: The median follow-up was 5.2 (interquartile range: 2.0-9.9) years. The 1-, 5-, 10- and 15-year rates of freedom from AF recurrence in the entire cohort were 91.4%, 83.5%, 76.2% and 57.1%, respectively. Risk factors for AF recurrence examined by logistic regression analysis included F-wave voltage in V1 < 0.2 mV, preoperative AF duration >5 years and left atrial volume index >100 ml/m2. Points were assigned to each risk factor according to its odds ratio. A novel risk score model was developed using these three variables and age, with a range up to 10 points. High score (>7) predicted high rates of AF recurrence after the Cryo-Maze procedure. The area under the receiver operating characteristic curve of the novel risk model score was 0.78 (95% confidence interval: 0.65-0.91) in the test cohort. CONCLUSIONS: Use of the Cryo-Maze procedure should be carefully considered in patients with a higher model score because of a higher risk of AF recurrence.
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Kakuta et al. (2020) conducted a cohort in Persistent atrial fibrillation (n=450). Novel risk score model was evaluated on Prediction of AF recurrence (Area under the receiver operating characteristic curve) (AUC 0.78, 95% CI 0.65-0.91). A novel risk score model using F-wave voltage, AF duration, left atrial volume index, and age predicted AF recurrence after the Cryo-Maze procedure with an AUC of 0.78 (95% CI 0.65-0.91).
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