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Synergistic Effect of the CHA2DS2-VASc Score and Left Atrial Epicardial Adipose Tissue Volume on Predicting Atrial

Chuanyi Sang1, Renjie Gu1, Tian Xia1

  • 1Department of Cardiology, Northern Jiangsu People's Hospital, Yangzhou, 225000, People's Republic of China.

Therapeutics and Clinical Risk Management
|March 18, 2025
PubMed

Insights

Combining CHA2DS2-VASc score and left atrial epicardial adipose tissue (LA-EAT) volume significantly increases atrial fibrillation (AF) recurrence risk after ablation. This combined assessment improves prediction of AF recurrence post-ablation.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Imaging

Background:

  • Atrial fibrillation (AF) recurrence post-ablation is a clinical challenge.
  • CHA2DS2-VASc score and left atrial epicardial adipose tissue (LA-EAT) volume are known AF risk factors.
  • The interaction between these risk factors for AF recurrence remains understudied.

Purpose of the Study:

  • To evaluate the combined predictive potential of CHA2DS2-VASc score and LA-EAT volume for AF recurrence after ablation.
  • To investigate the synergistic interaction between CHA2DS2-VASc score and LA-EAT volume in predicting AF recurrence.

Main Methods:

  • A cohort of 507 patients undergoing AF ablation was followed for 12 months.
  • AF recurrence was defined by ECG-documented AF or atrial tachycardia >30 seconds.
  • Cox regression and interaction analyses (RERI, AP, SI) assessed risk and synergy.

Main Results:

  • 140 patients (27.6%) experienced AF recurrence.
  • Both CHA2DS2-VASc score and LA-EAT volume were independent predictors of recurrence.
  • A significant synergistic interaction was found between CHA2DS2-VASc score and LA-EAT volume, enhancing predictive capabilities.

Conclusions:

  • A significant additive interaction exists between CHA2DS2-VASc score and LA-EAT volume.
  • The combination of these factors substantially increases AF recurrence risk post-ablation.
  • Integrating LA-EAT volume with clinical models improves AF recurrence prediction accuracy.
Abstract

Keywords:
CHA2DS2-VASc scoreatrial fibrillationcatheter ablationleft atrial epicardial adipose tissuerecurrence

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