title: [Impact of CHA2DS2 VASc score on substrate for persistent atrial fibrillation and outcome post catheter ablation of atrial fibrillation].
abstract: OBJECTIVE
  To explore if CHA2DS2 VASc score can predict substrate for persistent atrial fibrillation ( AF) and outcome post catheter ablation of AF.
  
  
  METHODS
  From January 2011 to December 2012,116 patients underwent catheter ablation of persistent AF in our department and were enrolled in this study. CHA2DS2VASc score was calculated as follows: two points were assigned for a history of stroke or transient ischemic attack and age ≥ 75 and 1 point each was assigned for age ≥ 65, a history of hypertension, diabetes,recent cardiac failure, vessel disease, female. Left atrial geometry ( LA) was reconstructed with a 3.5 mm tip ablation catheter with fill-in threshold 10 in CARTO system. The mapping catheter was stabled at each endocardial location for at least 3 seconds for recording. The electrogram recordings at each endocardial location were analyzed with a custom software embedded in the CARTO mapping system. Interval confidence level (ICL) was used to characterize complex fractionated atrial electrograms (CFAEs) . As the default setting of the software, ICL more than or equal to 7 was considered sites with a highly repetitive CFAEs complex. CFAEs index was defined as the fraction of area of ICL more than or equal to 7 to the left atrial surface. The CFAEs index and outcome of catheter ablation among different CHA2DS2VASc groups were compared.
  
  
  RESULTS
  Of the 116 patients, CHA2DS2VASc was 0 in 33 patients, 1 in 31 patients and ≥ 2 in 52 patients. Left atrial surface ((121.2 ± 18.9) cm2, (133.6 ± 23.8) cm2, (133.9 ± 16.1) cm2, P = 0.008), left atrial volume ((103.6 ± 24.8) ml, (118.3 ± 27.8) ml, (120.9 ± 20.9) ml, P = 0.005) and CFAEs index (44.6% ± 22.4%, 54.2% ± 22.2%, 58.7% ± 23.1%, P = 0.023) increased in proportion with increasing CHA2DS2VASc. ICLmax, ICLmin and CFAEs spatial distribution were similar among the three groups. During the mean follow-up of (13 ± 8) months, the recurrence rate were 36.4%, 35.5%, 55.8% among the three groups (P = 0.025).
  
  
  CONCLUSIONS
  A high CHA2DS2VASc score is associated with extensive AF substrate and higher recurrence rate post catheter ablation of persistent AF.
authors.forename: Tang
authors.initials: T
authors.lastname: Ribo
authors.forename: Dong
authors.initials: D
authors.lastname: Jianzeng
authors.forename: Liu
authors.initials: L
authors.lastname: Xiaohui
authors.forename: Shang
authors.initials: S
authors.lastname: Meisheng
authors.forename: Yu
authors.initials: Y
authors.lastname: Ronghui
authors.forename: Long
authors.initials: L
authors.lastname: Deyong
authors.forename: Du
authors.initials: D
authors.lastname: Xin
authors.forename: Kang
authors.initials: K
authors.lastname: Junping
authors.forename: Wu
authors.initials: W
authors.lastname: Jiahui
authors.forename: Ning
authors.initials: N
authors.lastname: Man
authors.forename: Sang
authors.initials: S
authors.lastname: Caihua
authors.forename: Jiang
authors.initials: J
authors.lastname: Chenxi
authors.forename: Bai
authors.initials: B
authors.lastname: Rong
authors.forename: Li
authors.initials: L
authors.lastname: Songnan
authors.forename: Yao
authors.initials: Y
authors.lastname: Yan
authors.forename: Wen
authors.initials: W
authors.lastname: Songnan
authors.forename: Ma
authors.initials: M
authors.lastname: Changsheng
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation; D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006325:Heart Atria; D006333:Heart Failure; D006801:Humans; D006973:Hypertension; D012008:Recurrence; D020521:Stroke; D016896:Treatment Outcome