Purpose

Subjective estimation of recurrence after atrial fibrillation ablation is an important tool in clinical use. The aim of this study is to evaluate (1) if the subjective complexity of an atrial fibrillation ablation procedure is correlated with rhythm stability and (2) if the subjective prognosis of the operator has a predictive value.

Methods

We prospectively enrolled patients admitted for ablation of atrial fibrillation. Two scores were given immediately after the procedure by the operator: the complexity and the prognosis scores. With routine follow-ups, we tried to evaluate the correlation between the subjective scores and measured outcome.

Results

The study population included 611 patients (63 ± 10 years, 37% females, 61% persistent AF). During follow-up (FU) (median 24, IQR 7–36 months), recurrences occurred in 44% patients. Both scores (prognosis and complexity) correlated significantly with age, persistent AF, LA diameter, procedural characteristics, and recurrences. On multivariable analysis, complexity (OR 1.304, 95%CI 1.016–1.675, p = 0.037) and prognosis (OR 1.443, 95%CI 1.080–1.982, p = 0.013) scores remained significant predictors for arrhythmia recurrences. On ROC analysis, both scores showed significant predictive value for rhythm outcomes after catheter ablation (AUC 0.599 and 0.613, both p < 0.001 for complexity and prognosis scores, respectively).

Conclusions

Complexity and prognosis scores are significant predictors for arrhythmia recurrences after AF catheter ablations and even independent when competing with simple risk factors.

中文翻译：

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肺静脉隔离后复杂性和预后的主观评估作为手术成功的重要预测因素

目的

房颤消融后复发的主观估计是临床使用的重要工具。本研究的目的是评估 (1) 房颤消融手术的主观复杂性是否与节律稳定性相关，以及 (2) 操作者的主观预后是否具有预测价值。

方法

我们前瞻性地招募了因房颤消融而入院的患者。操作者在手术后立即给出两个分数：复杂性和预后分数。通过常规随访，我们试图评估主观评分和测量结果之间的相关性。

结果

研究人群包括 611 名患者（63 ± 10 岁，37% 女性，61% 持续性 AF）。在随访 (FU) 期间（中位数 24，IQR 7-36 个月），44% 的患者发生复发。两个评分（预后和复杂性）都与年龄、持续性 AF、LA 直径、手术特征和复发显着相关。在多变量分析中，复杂性（OR 1.304, 95%CI 1.016–1.675, p = 0.037）和预后（OR 1.443, 95%CI 1.080–1.982, p = 0.013）评分仍然是心律失常复发的重要预测因素。在 ROC 分析中，两种评分均显示导管消融后节律结果的显着预测价值（AUC 0.599 和 0.613，复杂性和预后评分均 p < 0.001）。

结论

复杂性和预后评分是房颤导管消融后心律失常复发的重要预测因素，甚至在与简单危险因素竞争时也是独立的。