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CHA2DS2-VASc Score as a Predictor for Atrial Fibrillation Recurrence and Clinical Outcomes Following Pulmonary Vein
Mustafa Gabarin1, Mahmoud Suleiman2,3, Adi Elias2
1Cardiology Department, Meir Medical Center, Kfar-Saba and Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Summary
The CHA2DS2-VASc score predicts atrial fibrillation (AF) recurrence and adverse outcomes after pulmonary vein isolation (PVI). This score can help stratify risk in AF patients undergoing ablation.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Informatics
Background:
- Atrial fibrillation (AF) is a common arrhythmia linked to severe cardiovascular issues like stroke and heart failure.
- Pulmonary vein isolation (PVI) is a standard treatment for AF.
- The CHA2DS2-VASc score, typically for stroke risk, has not been fully evaluated for predicting PVI outcomes in real-world settings.
Purpose of the Study:
- To assess the relationship between the CHA2DS2-VASc score and AF recurrence post-PVI.
- To determine if the CHA2DS2-VASc score predicts adverse clinical outcomes after PVI.
Main Methods:
- A retrospective cohort study of 860 patients undergoing their first PVI for AF was conducted using the Israeli Catheter Ablation Registry (ICAR).
- Patients were stratified into CHA2DS2-VASc score groups: 0-1, 2-4, and >5.
- Primary endpoint was AF recurrence within 12 months; secondary endpoints included re-hospitalization, major adverse cardiovascular events (MACE), and all-cause mortality.
Main Results:
- AF recurrence was observed in 32% of patients, with rates of 25.7%, 31.4%, and 51% in low, intermediate, and high CHA2DS2-VASc score groups, respectively.
- A higher CHA2DS2-VASc score independently predicted increased AF recurrence risk (HR=2.88).
- Elevated scores correlated with higher rates of MACE and re-hospitalization, but not all-cause mortality.
Conclusions:
- The CHA2DS2-VASc score is an independent predictor of AF recurrence and adverse outcomes following PVI.
- Its ease of use and availability make it valuable for pre-procedural risk stratification in AF patients undergoing ablation.
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