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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
The Predictive Value of Real-World Cardiologist Performance (RWCP) Score in Atrial Fibrillation Recurrence Risk After
Yangyang Wang1, Jingchao He1, Yang Shao2
1Department of Cardiology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan Province, China.
Objective:
To explore the predictive value of Real-world Cardiologist Performance (RWCP) score for atrial fibrillation (AF) recurrence risk after radiofrequency catheter ablation (RFCA).
Methods:
Patients with nonvalvular AF who underwent first-time RFCA at Luoyang Central Hospital affiliated to Zhengzhou University between October 2021 and June 2023 were included in this study. Detailed ablation data were exported from CARTO®3 system (Biosense Webster, USA), based on which, four parameters, including discharge time proportion, Catheter Contact Force Stability (C3-FOT proportion), Ablation Index Consistency (SURPOINT/TOP-4 proportion) and fragmented points proportion, were calculated. Then, the RWCP score was calculated from these parameters for each patient. Predictive value of the RWCP score for AF recurrence risk were assessed using Cox regression and Kaplan-Meier analyses.
Results:
A total of 148 AF patients were enrolled, including 68 males and 80 females. During follow-up, 30 patients (20.3%) experienced AF recurrence. The RWCP score was calculated using Cox regression coefficients: RWCP score = (left ring discharge time ratio × 2.853) - (left C3-FOT proportion × 0.91) + (left SURPOINT/TOP4 × 2.943) + (left fragmented points proportion × 0.423) - (right ring discharge time ratio × 4.039) - (right C3-FOT proportion × 6.159) - (right SURPOINT/TOP4 × 1.312) - (right points fragmented proportion × 4.425). It was found that patients with higher RWCP scores (-12.53 to 5.79) had higher recurrence risk than those with low scores (-28.68 to -12.76) (HR = 5.55, 95% CI: 2.23-13.80, p = 0.0002). Kaplan-Meier analysis confirmed this (plog-rank < 0.001). To simplify the operation of RWCP, an online calculator was explored using shiny platform (https://doctorwanghao.shinyapps.io/RWCP_English/).
Conclusion:
The RWCP score shows promise as a tool for evaluating ablation completeness, assessing cardiologist performance and predicting AF recurrence risk after ablation.
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