Does the Antwerp score predict LVEF recovery after atrial fibrillation catheter ablation in patients with heart failure?
The Antwerp score is a valid and simple tool to predict LVEF recovery and clinical outcomes after AF ablation in patients with heart failure, aiding in shared decision-making.
AIMS: Management of patients with atrial fibrillation (AF) and concomitant heart failure (HF) remains complex. The Antwerp score, based on four parameters QRS >120 ms (2 points), known aetiology (2 points), paroxysmal AF (1 point), severe atrial dilation (1 point) adequately estimated the probability of left ventricular ejection fraction (LVEF) recovery after AF ablation in a single-centre cohort. The present study aims to externally validate this prediction model in a large European multi-centre cohort. METHODS AND RESULTS: A total of 605 patients (61.1 ± 9.4 years, 23.8% females, 79.8% with persistent AF) with HF and impaired LVEF ( 3. Responders experienced more often positive ventricular remodelling odds ratio (OR) 8.91, 95% CI 4.45-17.84, P < .001, fewer HF hospitalizations (OR 0.09, 95% CI 0.05-0.18, P < .001) and lower mortality (OR 0.11, 95% CI 0.04-0.31, P < .001). CONCLUSION: In this multi-centre study, a simple four-parameter score predicted LVEF recovery after AF ablation in patients with HF and discriminated clinical outcomes. These findings support the use of the Antwerp score to standardize shared decision-making regarding AF ablation referral in future clinical studies.
Bergonti et al. (Fri,) studied this question.