Key result
A higher CHA2DS2-VASc score was significantly associated with an increased risk of new-onset atrial fibrillation after cavotricuspid isthmus ablation for typical atrial flutter (HR 1.736).
Why the study?
Patients undergoing cavotricuspid isthmus ablation for typical atrial flutter remain at risk for new atrial fibrillation, but data on using the CHA2DS2-VASc score to predict postablation new-onset AF were limited.
Does the CHA2DS2-VASc score predict new-onset atrial fibrillation in patients undergoing catheter ablation for typical atrial flutter without prior AF?
Cohort (n=103)
No
Does the CHA2DS2-VASc score predict new-onset atrial fibrillation in patients undergoing catheter ablation for typical atrial flutter without prior AF?
Hazard Ratio: 1.736 (95% CI 1.37–2.201)
p-value: p=<0.001
The CHA2DS2-VASc score is a useful clinical tool for predicting new-onset atrial fibrillation following successful CTI ablation for typical atrial flutter, identifying high-risk patients who may require closer monitoring.
May warrant closer post-CTI ablation AF surveillance in high-score patients; leaves open need for prospective validation.
Purpose: Cavotricuspid isthmus (CTI) ablation is an effective procedure for typical atrial flutter (AFL), but patients remain at an elevated risk for developing new atrial fibrillation (AF). Currently, there is limited data on the utility of CHA2DS2-VASc score to predict new-onset AF after typical AFL ablation. In this study, we assessed whether the CHA2DS2-VASc score is a useful predictor of new-onset AF after CTI ablation in typical AFL patients without a prior history of AF. Methods: This was a retrospective study of 103 typical AFL patients with no prior history of AF, who underwent successful CTI ablation. The endpoint was occurrence of new-onset AF during follow-up. Results: During a mean follow-up period of 24.6±16.9 months, at least one episode of AF occurred in 33(32%) patients. Multivariate Cox regression analysis revealed that CHA2DS2-VASc score (hazard ratio 1.736; 95% confidence interval 1.370–2.201; P <0.001) was significantly associated with postablation new-onset AF (area under the curve: 0.797). A cut-off value of 3 stratified these patients into two groups with different incidence of postablation new-onset AF (67.9% vs. 18.7%, P＜0 .001). Conclusion: The CHA2DS2-VASc score is a useful tool for the prediction of new-onset AF after ablation of typical AFL. Patients with CHA2DS2-VASc score ≥3 are more likely to develop new-onset AF and should be monitored more closely.
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Liu et al. (2020) conducted a cohort in Typical atrial flutter (n=103). CHA2DS2-VASc score vs. Lower CHA2DS2-VASc score was evaluated on New-onset atrial fibrillation (HR 1.736, 95% CI 1.370-2.201, p=<0.001). A higher CHA2DS2-VASc score was significantly associated with an increased risk of new-onset atrial fibrillation after cavotricuspid isthmus ablation for typical atrial flutter (HR 1.736).
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