title: Prediction of very late arrhythmia recurrence after radiofrequency catheter ablation of atrial fibrillation: The MB-LATER clinical score.
abstract: Reliable prediction of very late recurrence of atrial fibrillation (VLRAF) occuring >12 months after catheter ablation (CA) in apparently "cured" patients could optimize long-term follow-up and modify decision-making regarding the discontinuation of oral anticoagulant therapy. In a single-centre cohort of consecutive patients post radiofrequency AFCA, we retrospectively derived a novel score for VLRAF prediction. Of 133 consecutive post AFCA patients (mean age 56.9 ± 11.8 years, 63.9% male, 69.2% with paroxysmal AF) who were arrhythmia-free at 12 months (excluding 3-month "blanking period"), 20 patients expirienced a VLRAF during a 29.1 ± 10.1-month follow-up, with a 3-year cumulative VLRAF rate of 31.1%. The MB-LATER score (Male, Bundle brunch block, Left atrium ≥47 mm, Type of AF [paroxysmal, persistent or long-standing persistent], and ER-AF = early recurrent AF), had better predictive ability for VLRAF (AUC 0.782) than the APPLE, ALARMc, BASE-AF2, CHADS2, CHA2DS2VASc or HATCH score (AUC 0.716, 0.671, 0.648, 0.552, 0.519 and 0.583, respectively), resulted in an improved net reclassification index (NRI) of 48.6-95.1% and better identified patients with subsequent VLRAF using decision-curve analysis (DCA). The MB-LATER score provides a readily available VLRAF risk assessment, and performs better than other scores. Validation of the MB-LATER score in other cohorts is underway.
authors.affiliation: Cardiology Clinic, Clinical Center of Serbia, Višegradska 26, Belgrade, Serbia.|School of Medicine, University of Belgrade, Dr Subotića 8, Belgrade, Serbia.
authors.forename: Nebojša
authors.initials: N
authors.lastname: Mujović
authors.affiliation: Cardiology Clinic, Clinical Center of Serbia, Višegradska 26, Belgrade, Serbia.
authors.forename: Milan
authors.initials: M
authors.lastname: Marinković
authors.affiliation: Cardiology Clinic, Clinical Center of Serbia, Višegradska 26, Belgrade, Serbia.
authors.forename: Nebojša
authors.initials: N
authors.lastname: Marković
authors.affiliation: University of Birmingham Institute of Cardiovascular Science, City Hospital, Birmingham, United Kingdom.
authors.forename: Alena
authors.initials: A
authors.lastname: Shantsila
authors.affiliation: School of Medicine, University of Belgrade, Dr Subotića 8, Belgrade, Serbia.|University of Birmingham Institute of Cardiovascular Science, City Hospital, Birmingham, United Kingdom.
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.affiliation: Cardiology Clinic, Clinical Center of Serbia, Višegradska 26, Belgrade, Serbia.|School of Medicine, University of Belgrade, Dr Subotića 8, Belgrade, Serbia.
authors.forename: Tatjana S
authors.initials: TS
authors.lastname: Potpara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D057188:Workflow; D055815:Young Adult