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A nomogram integrating the CHA2DS2-VASc score for predicting atrial fibrillation recurrence following catheter

Lin-Qian Jiang1,2, Yu-Hong Zhong1,3, Xue-Hai Chen1

  • 1Department of Cardiology, Fujian Clinical Medical Research Center for Heart and Macrovascular Disease, Fujian Medical University Union Hospital, Fujian Heart Medical Center, Fujian Institute of Coronary Heart Disease, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.

BMC Cardiovascular Disorders
|October 1, 2025
PubMed

Insights

A new nomogram incorporating the CHA2DS2-VASc score shows promise in predicting atrial fibrillation (AF) recurrence after catheter ablation. This tool may improve risk assessment for patients undergoing AF ablation procedures.

Area of Science:

  • Cardiology
  • Medical Informatics

Background:

  • Atrial fibrillation (AF) recurrence after catheter ablation remains a clinical challenge.
  • Existing risk stratification tools may not fully capture post-ablation recurrence risk.

Purpose of the Study:

  • To develop and validate a nomogram for predicting AF recurrence post-catheter ablation.
  • To compare the predictive efficacy of the nomogram against the CHA2DS2-VASc score.

Main Methods:

  • A retrospective analysis of 398 patients undergoing first-time catheter ablation for symptomatic AF.
  • Univariate and multivariate analyses to identify independent risk factors for AF recurrence.
  • Construction of a predictive nomogram using R programming language incorporating CHA2DS2-VASc score, AF duration, neutrophil-to-lymphocyte ratio (NLR), and left atrial diameter (LAD).

Main Results:

  • Independent risk factors for AF recurrence included AF duration, blanking period recurrence, neutrophil granulocyte count, NLR, red blood cell distribution width, and LAD.
  • The developed nomogram demonstrated a higher predictive value (C-index: 0.707) compared to the CHA2DS2-VASc score alone (C-index: 0.499).
  • NLR, LAD, AF duration, and CHA2DS2-VASc score were significant predictors in the nomogram, with NLR showing the highest predictive power.

Conclusions:

  • A novel nomogram integrating CHA2DS2-VASc score, AF duration, NLR, and LAD effectively predicts 12-month AF recurrence post-ablation.
  • The nomogram offers improved risk stratification compared to the CHA2DS2-VASc score alone.
  • Further external validation is necessary to confirm the nomogram's reliability and generalizability.
Abstract

Keywords:
Atrial fibrillationCHA2DS2-VASc scoreCatheter ablationNomogramRecurrence

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