title: Comparison of CHADS2, R2CHADS2, and CHA2DS2-VASc scores for the prediction of rhythm outcomes after catheter ablation of atrial fibrillation: the Leipzig Heart Center AF Ablation Registry.
abstract: BACKGROUND
  Recurrences of atrial fibrillation (AF) occur in up to 30% within 1 year after catheter ablation. This study evaluated the value of CHADS2, R2CHADS2, and CHA2DS2-VASc scores for the prediction of rhythm outcomes after AF catheter ablation.
  
  
  RESULTS
  Using the Leipzig Heart Center AF Ablation Registry, we documented rhythm outcomes within the first 12 months in 2069 patients (67% men; 60±10 years; 35% persistent AF) undergoing AF catheter ablation. AF recurrences were defined as any atrial arrhythmia occurring within the first week (early recurrences, ERAF) and between 3 and 12 months (late recurrences, LRAF) after ablation. ERAF and LRAF occurred in 36% and 33%, respectively. On multivariable analysis, R2CHADS2 (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.02-1.21; P=0.016) and CHA2DS2-VASc (OR, 1.09; 95% CI, 1.017-1.17; P=0.015) scores as well as persistent AF and left atrial diameter were significant predictors for ERAF. Similarly, the same clinical variables remained significant predictors for LRAF even after adjustment for ERAF, which was the strongest predictor for LRAF (HR, 3.12; 95% CI, 2.62-3.71; P<0.001). However, using receiver operating characteristic curve analyses, both scores demonstrated relatively low predictive value for ERAF (area under the curve [AUC], 0.536 [0.510-0.563]; P=0.007; and AUC, 0.547 [0.521-0.573]; P<0.001 for R2CHADS2 and CHA2DS2-VASc, respectively) and LRAF (AUC, 0.548 [0.518-0.578]; P=0.002; and AUC, 0.550 [0.520-0.580]; P=0.001).
  
  
  CONCLUSIONS
  R2CHADS2 and CHA2DS2-VASc were associated with rhythm outcomes after catheter ablation. However, AF type, left atrial diameter, and especially ERAF are also significant predictors for LRAF that should be included into new clinical scores for the prediction of rhythm outcomes after catheter ablation.
authors.affiliation: University of Leipzig, Heart Center, Department of Electrophysiology, Leipzig, Germany.
authors.forename: Jelena
authors.initials: J
authors.lastname: Kornej
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hindricks
authors.forename: Jedrzej
authors.initials: J
authors.lastname: Kosiuk
authors.forename: Arash
authors.initials: A
authors.lastname: Arya
authors.forename: Philipp
authors.initials: P
authors.lastname: Sommer
authors.forename: Daniela
authors.initials: D
authors.lastname: Husser
authors.forename: Sascha
authors.initials: S
authors.lastname: Rolf
authors.forename: Sergio
authors.initials: S
authors.lastname: Richter
authors.forename: Yan
authors.initials: Y
authors.lastname: Huo
authors.forename: Christopher
authors.initials: C
authors.lastname: Piorkowski
authors.forename: Andreas
authors.initials: A
authors.lastname: Bollmann
mesh_terms: D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012372:ROC Curve; D012008:Recurrence; D012042:Registries; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: CHA2DS2-VASc score; atrial fibrillation; catheter ablation; recurrences; renal dysfunction