What is the clinical evidence from this study?

Study design: Cohort. Population: Atrial fibrillation (n=1065). Intervention: HASBLP score vs. CHADS2 and CHA2DS2-Vasc scores. Primary outcome: Atrial fibrillation recurrence (AUC 0.7668, 95% CI 0.7298-0.8037).

September 6, 2022Open Access

A prediction model of atrial fibrillation recurrence after first catheter ablation by a nomogram: HASBLP score

WHWenqiang HanQilu Hospital of Shandong University YLYan LiuGeneral Cardiology RSRina ShaElectrophysiology

Key Result

The HASBLP score predicted atrial fibrillation recurrence after first catheter ablation with an AUC of 0.7668 (95% CI 0.7298-0.8037), outperforming CHADS2 and CHA2DS2-Vasc scores.

Study Design

Type

Cohort (n=1,065)

Structured PICO

Does the HASBLP score improve the prediction of AF recurrence after first catheter ablation compared to CHADS2 and CHA2DS2-Vasc scores in patients with atrial fibrillation?

Population

1,065 patients with atrial fibrillation undergoing their first catheter ablation, median age 61, 63% male, based in China. Key exclusions: previous history of catheter ablation, <24 months of follow-up, or cardiac surgery during the follow-up period.

Intervention

HASBLP score (a predictive nomogram model incorporating AF history, age, snoring, BMI, left atrial anteroposterior diameter, and persistent AF)

Comparator

CHADS2 and CHA2DS2-Vasc scores

Outcome

AF recurrence (defined as symptomatic or documented AF, atrial flutter, or atrial tachycardia >30s after a 3-month blanking period) at 2-year follow-upcomposite

The HASBLP score provides a simple, nomogram-based clinical tool that outperforms traditional CHADS2 and CHA2DS2-VASc scores in predicting atrial fibrillation recurrence 2 years after first-time catheter ablation.

Main Result

Effect estimate: AUC 0.7668 (95% CI 0.7298-0.8037)

Limitations

Usefulness needs further validation

Abstract

Background At present, catheter ablation is an effective method for rhythm control in patients with atrial fibrillation (AF). However, AF recurrence is an inevitable problem after catheter ablation. To identify patients who are prone to relapse, we developed a predictive model that allows clinicians to closely monitor these patients and treat them with different personalized treatment plans. Materials and methods A total of 1,065 patients who underwent AF catheter ablation between January 2015 and December 2018 were consecutively included in this study, which examines the results of a 2-year follow-up. Patients with AF were divided into development cohort and validation cohort. Univariate and multivariate analyses were carried out on the potential risk factors. Specific risk factors were used to draw the nomogram according to the above results. Finally, we verified the performance of our model compared with CHADS2 and CHA 2 DS 2 -Vasc scores by receiver operating characteristic (ROC) curve and calibration curve and plotted the decision analysis curve (DAC). Results A total of 316 patients experienced AF recurrence. After univariate and multivariate analyses, AF history (H), age (A), snoring (S), body mass index (BMI) (B), anteroposterior diameter of left atrial (LA) (L), and persistent AF (P) were included in our prediction model. Our model showed a better performance compared with CHADS2 and CHA2DS2-Vasc scores, and the area under ROC curve (95%CI) was 0.7668 (0.7298–0.8037) vs. 0.6225 (0.5783–0.6666) and 0.6267 (0.5836–0.6717). Conclusion We established a nomogram (HASBLP score) for predicting AF recurrence after the first catheter ablation at a 2-year follow-up, which can be used as a tool to guide future follow-up of patients. However, its usefulness needs further validation.

AI에게 질문

Bookmark

View Full Paper