Abstract 12471: CHA2DS2VASc Score Predicts Future Development of Atrial Fibrillation After Successful Catheter Ablation of Typical Atrial–Flutter
Introduction: After successful catheter ablation (CA) for typical atrial flutter (AFL), long term development of atrial fibrillation (AF) is common. No definitive predictive models currently exist to identify patients who are likely to develop AF. The aim of this study was to evaluate whether CHA2DS2VASc score can predict future occurrence of AF after successful CA of AFL.
Methods: We conducted a retrospective chart review of 171 consecutive patients with isolated AFL who underwent successful CA between years 2007-2014 at a teaching community hospital. Patients with at least 2 years of follow-up were included for analysis. 40 patients were lost to follow-up. CHA2DS2VASc scores were calculated at the time of CA. Follow up consisted of in-office electrocardiograms, and (when available) in-office and remote device interrogation. Patients were anticoagulated at the discretion of their treating physician. The endpoint was time to first occurrence of AF. Data was analyzed using appropriate descriptive and univariate statistics to describe, compare and contrast based upon AF occurrence groups. A cox regression was performed to examine CHA2DS2VASc score as a predictor of AF occurrence during CA follow-up.
Results: 131 patients were included in the study. Average age was 66 ±11.5 years and follow-up duration was 26.6±1.5 months. AF occurred in 52 patients (39.7%) by 2 years. Patients who developed AF had a CHA2DS2VASc score of 3.4±1.4, compared to 2.6±1.3 for patients who did not (p < 0.003). Patients who developed AF were also older (70.2±10.3 vs. 63.7±11.6 years, p<.001,), and had a higher rate of Hypertension (3.40±1.35 vs. 2.6±1.3, p=.037,). CHA2DS2VASc score was found to be significantly associated with AF onset during the 2 year follow-up (p<.007, Hazard Ratio 1.36, 95%CI 1.09-1.70).
Conclusion: The incidence of AF following CA of AFL is common. CHA2DS2VASc score may be a useful tool and predictor of AF after typical AFL ablation. This needs to be evaluated further in larger randomized trials which may help in guiding long term anticoagulation therapy.
Author Disclosures: A. Bhan: None. P. Dunskis: None. J.S. Neiger: Honoraria; Modest; from biosense webster and Daiichi Sankyo. Consultant/Advisory Board; Modest; consulting fees. C. Blair: None. M. Duggal: Speakers Bureau; Modest; for BMS and Pfizer. Consultant/Advisory Board; Modest; for medtronic.
- © 2016 by American Heart Association, Inc.