Utility of Post‐Procedural HFA ‐ PEFF Reassessment for Long‐Term Heart Failure Risk Stratification After Atrial Fibrillation Ablation

Figures

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  FIGURE 1. Pre‐ to post‐procedural shifts in HFA‐PEFF after AF ablation. Sankey‐style flow diagrams show pre‐ to post‐procedural shifts in HFA‐PEFF risk classification (A) and domain scores (B). AF, atrial fibrillation; HFA‐PEFF, Heart Failure Association Pretest assessment, Echocardiography and natriuretic peptide, Functional testing, and Final etiology.

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  FIGURE 2. Cumulative probability of HF hospitalization by HFA‐PEFF risk category Kaplan–Meier curves show the cumulative probability of HF hospitalization from 1 year after the index ablation, stratified by pre‐procedural (A) and post‐procedural (B) HFA‐PEFF risk categories. CI, confidence interval; HF, heart failure; HFA‐PEFF, Heart Failure Association Pretest assessment, Echocardiography and natriuretic peptide, Functional testing, and Final etiology.

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  FIGURE 3. Time‐dependent discrimination of HF hospitalization using pre‐ and post‐procedural HFA‐PEFF Time‐dependent receiver operating characteristic curves show discrimination for HF hospitalization by pre‐ and post‐procedural HFA‐PEFF scores at 2–5 years after the index procedure (A‐D). HF, heart failure; HFA‐PEFF, Heart Failure Association Pretest assessment, Echocardiography and natriuretic peptide, Functional testing, and Final etiology; ROC, receiver operating characteristic.

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  FIGURE 4. Stratification after ablation based on changes in HFA‐PEFF and the biomarker domain Kaplan–Meier curves show the cumulative probability of HF hospitalization by improvement status, defined as improved (Δ ≤ −1) or not improved (Δ ≥ 0), according to ΔHFA‐PEFF and Δbiomarker domain in baseline High‐risk (A, B) and Low/Intermediate‐risk (C, D) strata. Time‐dependent receiver operating characteristic curves compare discrimination by ΔHFA‐PEFF and Δbiomarker domain at 5 years in baseline High‐risk (E) and Low/Intermediate‐risk (F) strata. CI, confidence interval; HF, heart failure; HFA‐PEFF, Heart Failure Association Pretest assessment, Echocardiography and natriuretic peptide, Functional testing, and Final etiology; ROC, receiver operating characteristic.