CHA2DS2‐VASc Score as a Predictor for Atrial Fibrillation Recurrence and Clinical Outcomes Following Pulmonary Vein Isolation
ABSTRACT Background Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with serious cardiovascular complications such as ischemic stroke, heart failure, and myocardial infarction. Pulmonary vein isolation (PVI) is an established rhythm‐control strategy for...
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Published in | Annals of noninvasive electrocardiology Vol. 30; no. 3; pp. e70088 - n/a |
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Main Authors | , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Hoboken
John Wiley and Sons Inc
01.05.2025
Wiley |
Subjects | |
Online Access | Get full text |
ISSN | 1082-720X 1542-474X 1542-474X |
DOI | 10.1111/anec.70088 |
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Abstract | ABSTRACT
Background
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with serious cardiovascular complications such as ischemic stroke, heart failure, and myocardial infarction. Pulmonary vein isolation (PVI) is an established rhythm‐control strategy for AF. Although the CHA2DS2‐VASc score is primarily used to estimate stroke risk in patients with AF, its potential utility in predicting AF recurrence after PVI has not been fully explored in contemporary, real‐world multicenter settings.
Aim
To evaluate the association between the CHA2DS2‐VASc score and both AF recurrence and adverse clinical outcomes following PVI.
Methods
We conducted a retrospective cohort study using the Israeli Catheter Ablation Registry (ICAR), including 860 patients undergoing their first PVI for AF. Patients were grouped by CHA2DS2‐VASc score (0–1, 2–4, > 5). The primary endpoint was AF recurrence within 12 months. Secondary endpoints included re‐hospitalization, major adverse cardiovascular events (MACE), and all‐cause mortality.
Results
AF recurrence occurred in 32% of patients. Recurrence rates were 25.7%, 31.4%, and 51% across the low, intermediate, and high CHA2DS2‐VASc score groups, respectively. A higher score was independently associated with increased recurrence risk (HR = 2.88; 95% CI, 1.75–4.74; p < 0.001). Elevated CHA2DS2‐VASc scores also correlated with higher MACE and re‐hospitalization rates. No significant difference in all‐cause mortality was observed.
Conclusion
The CHA2DS2‐VASc score is an independent predictor of AF recurrence and adverse outcomes after PVI. Its simplicity, availability, and routine use make it a clinically useful tool to support preprocedural risk stratification in AF patients undergoing ablation.
The CHA2DS2‐VASc score independently predicts atrial fibrillation recurrence and adverse outcomes after pulmonary vein isolation. Its routine clinical use offers a simple tool to support risk stratification and personalized post‐ablation care. |
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AbstractList | ABSTRACT Background Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with serious cardiovascular complications such as ischemic stroke, heart failure, and myocardial infarction. Pulmonary vein isolation (PVI) is an established rhythm‐control strategy for AF. Although the CHA2DS2‐VASc score is primarily used to estimate stroke risk in patients with AF, its potential utility in predicting AF recurrence after PVI has not been fully explored in contemporary, real‐world multicenter settings. Aim To evaluate the association between the CHA2DS2‐VASc score and both AF recurrence and adverse clinical outcomes following PVI. Methods We conducted a retrospective cohort study using the Israeli Catheter Ablation Registry (ICAR), including 860 patients undergoing their first PVI for AF. Patients were grouped by CHA2DS2‐VASc score (0–1, 2–4, > 5). The primary endpoint was AF recurrence within 12 months. Secondary endpoints included re‐hospitalization, major adverse cardiovascular events (MACE), and all‐cause mortality. Results AF recurrence occurred in 32% of patients. Recurrence rates were 25.7%, 31.4%, and 51% across the low, intermediate, and high CHA2DS2‐VASc score groups, respectively. A higher score was independently associated with increased recurrence risk (HR = 2.88; 95% CI, 1.75–4.74; p < 0.001). Elevated CHA2DS2‐VASc scores also correlated with higher MACE and re‐hospitalization rates. No significant difference in all‐cause mortality was observed. Conclusion The CHA2DS2‐VASc score is an independent predictor of AF recurrence and adverse outcomes after PVI. Its simplicity, availability, and routine use make it a clinically useful tool to support preprocedural risk stratification in AF patients undergoing ablation. The CHA 2 DS 2 ‐VASc score independently predicts atrial fibrillation recurrence and adverse outcomes after pulmonary vein isolation. Its routine clinical use offers a simple tool to support risk stratification and personalized post‐ablation care. ABSTRACT Background Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with serious cardiovascular complications such as ischemic stroke, heart failure, and myocardial infarction. Pulmonary vein isolation (PVI) is an established rhythm‐control strategy for AF. Although the CHA2DS2‐VASc score is primarily used to estimate stroke risk in patients with AF, its potential utility in predicting AF recurrence after PVI has not been fully explored in contemporary, real‐world multicenter settings. Aim To evaluate the association between the CHA2DS2‐VASc score and both AF recurrence and adverse clinical outcomes following PVI. Methods We conducted a retrospective cohort study using the Israeli Catheter Ablation Registry (ICAR), including 860 patients undergoing their first PVI for AF. Patients were grouped by CHA2DS2‐VASc score (0–1, 2–4, > 5). The primary endpoint was AF recurrence within 12 months. Secondary endpoints included re‐hospitalization, major adverse cardiovascular events (MACE), and all‐cause mortality. Results AF recurrence occurred in 32% of patients. Recurrence rates were 25.7%, 31.4%, and 51% across the low, intermediate, and high CHA2DS2‐VASc score groups, respectively. A higher score was independently associated with increased recurrence risk (HR = 2.88; 95% CI, 1.75–4.74; p < 0.001). Elevated CHA2DS2‐VASc scores also correlated with higher MACE and re‐hospitalization rates. No significant difference in all‐cause mortality was observed. Conclusion The CHA2DS2‐VASc score is an independent predictor of AF recurrence and adverse outcomes after PVI. Its simplicity, availability, and routine use make it a clinically useful tool to support preprocedural risk stratification in AF patients undergoing ablation. The CHA2DS2‐VASc score independently predicts atrial fibrillation recurrence and adverse outcomes after pulmonary vein isolation. Its routine clinical use offers a simple tool to support risk stratification and personalized post‐ablation care. Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with serious cardiovascular complications such as ischemic stroke, heart failure, and myocardial infarction. Pulmonary vein isolation (PVI) is an established rhythm-control strategy for AF. Although the CHA2DS2-VASc score is primarily used to estimate stroke risk in patients with AF, its potential utility in predicting AF recurrence after PVI has not been fully explored in contemporary, real-world multicenter settings.BACKGROUNDAtrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with serious cardiovascular complications such as ischemic stroke, heart failure, and myocardial infarction. Pulmonary vein isolation (PVI) is an established rhythm-control strategy for AF. Although the CHA2DS2-VASc score is primarily used to estimate stroke risk in patients with AF, its potential utility in predicting AF recurrence after PVI has not been fully explored in contemporary, real-world multicenter settings.To evaluate the association between the CHA2DS2-VASc score and both AF recurrence and adverse clinical outcomes following PVI.AIMTo evaluate the association between the CHA2DS2-VASc score and both AF recurrence and adverse clinical outcomes following PVI.We conducted a retrospective cohort study using the Israeli Catheter Ablation Registry (ICAR), including 860 patients undergoing their first PVI for AF. Patients were grouped by CHA2DS2-VASc score (0-1, 2-4, > 5). The primary endpoint was AF recurrence within 12 months. Secondary endpoints included re-hospitalization, major adverse cardiovascular events (MACE), and all-cause mortality.METHODSWe conducted a retrospective cohort study using the Israeli Catheter Ablation Registry (ICAR), including 860 patients undergoing their first PVI for AF. Patients were grouped by CHA2DS2-VASc score (0-1, 2-4, > 5). The primary endpoint was AF recurrence within 12 months. Secondary endpoints included re-hospitalization, major adverse cardiovascular events (MACE), and all-cause mortality.AF recurrence occurred in 32% of patients. Recurrence rates were 25.7%, 31.4%, and 51% across the low, intermediate, and high CHA2DS2-VASc score groups, respectively. A higher score was independently associated with increased recurrence risk (HR = 2.88; 95% CI, 1.75-4.74; p < 0.001). Elevated CHA2DS2-VASc scores also correlated with higher MACE and re-hospitalization rates. No significant difference in all-cause mortality was observed.RESULTSAF recurrence occurred in 32% of patients. Recurrence rates were 25.7%, 31.4%, and 51% across the low, intermediate, and high CHA2DS2-VASc score groups, respectively. A higher score was independently associated with increased recurrence risk (HR = 2.88; 95% CI, 1.75-4.74; p < 0.001). Elevated CHA2DS2-VASc scores also correlated with higher MACE and re-hospitalization rates. No significant difference in all-cause mortality was observed.The CHA2DS2-VASc score is an independent predictor of AF recurrence and adverse outcomes after PVI. Its simplicity, availability, and routine use make it a clinically useful tool to support preprocedural risk stratification in AF patients undergoing ablation.CONCLUSIONThe CHA2DS2-VASc score is an independent predictor of AF recurrence and adverse outcomes after PVI. Its simplicity, availability, and routine use make it a clinically useful tool to support preprocedural risk stratification in AF patients undergoing ablation. |
Author | Suleiman, Mahmoud Elias, Adi Pereg, David Omelchenko, Alexander Nof, Eyal Michowitz, Yoav Luria, David Konstantino, Yuval Marai, Ibrahim Gabarin, Mustafa Glikson, Michael Beinart, Roy Laish‐Farkash, Avishag Haim, Moti |
AuthorAffiliation | 9 Department of Cardiology, Electrophysiology and Pacing Unit Assuta Ashdod University Medical Center, ben‐Gurion University of the Negev Ashdod Israel 7 Department of Cardiology, Cardiac Electrophysiology and Pacing Soroka University Hospital, ben‐Gurion University of the Negev Beer‐Sheva Israel 5 Heart Institute, Sheba Medical Center, Tel‐Hashomer, Israel and Sackler School of Medicine Tel Aviv Israel 3 Rappaport Faculty of Medicine Technion‐Israel Institute of Technology Haifa Israel 6 Jesselson Integrated Heart Center Shaare Zedek Medical Center and Hebrew University Jerusalem Israel 1 Cardiology Department, Meir Medical Center, Kfar‐Saba and Sackler Faculty of Medicine Tel‐Aviv University Tel Aviv Israel 8 Department of Cardiology, Hadassah Medical Organization and Faculty of Medicine Hebrew University of Jerusalem Jerusalem Israel 4 Cardiology Department, Baruch Padeh Medical Center, the Azrieli Faculty of Medicine in the Galilee Bar‐Ilan University Safed Israel 2 Eyal Ofer Heart Hospita |
AuthorAffiliation_xml | – name: 2 Eyal Ofer Heart Hospital, Cardiac Electrophysiology and Pacing Rambam Health Care Campus Haifa Israel – name: 1 Cardiology Department, Meir Medical Center, Kfar‐Saba and Sackler Faculty of Medicine Tel‐Aviv University Tel Aviv Israel – name: 7 Department of Cardiology, Cardiac Electrophysiology and Pacing Soroka University Hospital, ben‐Gurion University of the Negev Beer‐Sheva Israel – name: 9 Department of Cardiology, Electrophysiology and Pacing Unit Assuta Ashdod University Medical Center, ben‐Gurion University of the Negev Ashdod Israel – name: 5 Heart Institute, Sheba Medical Center, Tel‐Hashomer, Israel and Sackler School of Medicine Tel Aviv Israel – name: 6 Jesselson Integrated Heart Center Shaare Zedek Medical Center and Hebrew University Jerusalem Israel – name: 3 Rappaport Faculty of Medicine Technion‐Israel Institute of Technology Haifa Israel – name: 4 Cardiology Department, Baruch Padeh Medical Center, the Azrieli Faculty of Medicine in the Galilee Bar‐Ilan University Safed Israel – name: 8 Department of Cardiology, Hadassah Medical Organization and Faculty of Medicine Hebrew University of Jerusalem Jerusalem Israel |
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Notes | Mustafa Gabarin, Mahmoud Suleiman, Adi Elias, Ibrahim Marai, Roy Beinart, Eyal Nof, Yoav Michowitz, Michael Glikson, Yuval Konstantino, Moti Haim, David Luria, David Pereg, Avishag Laish‐Farkash, and Alexander Omelchenko takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
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Background
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with serious cardiovascular complications... Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with serious cardiovascular complications such as ischemic... The CHA 2 DS 2 ‐VASc score independently predicts atrial fibrillation recurrence and adverse outcomes after pulmonary vein isolation. Its routine clinical use... ABSTRACT Background Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with serious cardiovascular complications... |
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SubjectTerms | AF recurrence atrial fibrillation (AF) CHA2DS2‐VASc score Original pulmonary vein isolation (PVI) |
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Title | CHA2DS2‐VASc Score as a Predictor for Atrial Fibrillation Recurrence and Clinical Outcomes Following Pulmonary Vein Isolation |
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