The Predictive Value of the APPLE Score for the Atrial Fibrillation Recurrence Post the First-time Radiofrequency Ablation in Chinese Populations

Background: Recurrence is a problem that needs attention in radiofrequency ablation of atrial fibrillation (AF), and several scores have been designed to predict the probability of atrial fibrillation recurrence after radiofrequency ablation. We aimed to investigate APPLE score's predicting values in Chinese AF patients undergoing AF radiofrequency ablation therapy. Methods: 198 patients with non-valvular AF treated with their first radiofrequency ablation in the First Affiliated Hospital of Chongqing Medical University were continuously enrolled. A multivariate Cox regression model was established to explore the clinical factors potentially related to AF recurrence. The receiver operating characteristics curve was used to determine the APPLE score with the best predictive ability. Results: After a mean follow-up of 16 months (5-28months), AF recurrence was recorded in 45 (22.7%) patients. The AF recurrence risk was increased by 4.19 times in patients withthe APPLE score >1 compared with those with a score of 0 and1 (HR 4.19, 95%CI: 2.12-8.27,P<0.05).The multivariate Cox regression was used to explore the potential association of components of APPLE score with the recurrence risk of AF.The result showed that NPAF (HR:2.43,95%CI:1.41-5.20,P<0.05) and Left atrial diameter (LAD) 43mm (HR:3.52,95%CI:1.38-8.90,P<0.05) were significantly associated with increased AF recurrence chance after ablation.Conclusions: APPLE score shows the excellent predictive ability for AF recurrence after catheter ablation in Chinese AF patients.Because of China's medical reality, the APPLE score will be beneficial for clinicians to formulate the most reasonable treatment strategies for patients with atrial fibrillation.