BMC cardiovascular disorders · 2025
A nomogram integrating the CHA2DS2-VASc score for predicting atrial fibrillation recurrence following catheter ablation.
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Jiang Lin-Qian, Zhong Yu-Hong, Chen Xue-Hai, Xu Zhe, Gong Ke-Zeng, Zhang Fei-Long
Аннотация
OBJECTIVE: This study aimed to explore the predictive efficacy of a nomogram based on the congestive heart failure, hypertension, age, diabetes mellitus, prior stroke, transient ischemic attack or thromboembolism, vascular disease, age, and sex category (CHA2DS2-VASc) score in predicting atrial fibrillation (AF) recurrence following first-time catheter ablation in patients with symptomatic AF.
METHODS: Clinical data of 398 patients were collected and analyzed. Patients were divided into a recurrence group (n = 81) and a non-recurrence group (n = 317). Key predictive factors were identified through univariate and multivariate analyses, and a nomogram was subsequently constructed using the R programming language.
RESULTS: The duration of AF, recurrence during the blanking period, neutrophil granulocyte count, neutrophil-to-lymphocyte ratio (NLR), red blood cell distribution width, and left atrial diameter (LAD) were identified as independent risk factors for AF recurrence (p < 0.05). A predictive model incorporating the CHA2DS2-VASc score, AF duration, NLR, and LAD was constructed. Among these variables, NLR exhibited the highest predictive value for postoperative recurrence of AF, followed by LAD, AF duration, and the CHA2DS2-VASc score. The concordance index (C-index) of the nomogram was 0.707 (95% CI: 0.566-0.847), which was significantly higher than that of the CHA2DS2-VASc score (C-index: 0.499; 95% CI: 0.359-0.640). The prediction model that was developed demonstrated clinical utility for assessing the risk of late recurrence across different AF subtypes and ablation techniques (AUC > 0.5).
CONCLUSION: A nomogram incorporating the CHA2DS2-VASc score was developed to predict the recurrence of AF following ablation. It demonstrated promise in predicting the probability of recurrence 12 months post-ablation. However, further validation is required to confirm its reliability and generalizability.
METHODS: Clinical data of 398 patients were collected and analyzed. Patients were divided into a recurrence group (n = 81) and a non-recurrence group (n = 317). Key predictive factors were identified through univariate and multivariate analyses, and a nomogram was subsequently constructed using the R programming language.
RESULTS: The duration of AF, recurrence during the blanking period, neutrophil granulocyte count, neutrophil-to-lymphocyte ratio (NLR), red blood cell distribution width, and left atrial diameter (LAD) were identified as independent risk factors for AF recurrence (p < 0.05). A predictive model incorporating the CHA2DS2-VASc score, AF duration, NLR, and LAD was constructed. Among these variables, NLR exhibited the highest predictive value for postoperative recurrence of AF, followed by LAD, AF duration, and the CHA2DS2-VASc score. The concordance index (C-index) of the nomogram was 0.707 (95% CI: 0.566-0.847), which was significantly higher than that of the CHA2DS2-VASc score (C-index: 0.499; 95% CI: 0.359-0.640). The prediction model that was developed demonstrated clinical utility for assessing the risk of late recurrence across different AF subtypes and ablation techniques (AUC > 0.5).
CONCLUSION: A nomogram incorporating the CHA2DS2-VASc score was developed to predict the recurrence of AF following ablation. It demonstrated promise in predicting the probability of recurrence 12 months post-ablation. However, further validation is required to confirm its reliability and generalizability.