Kornej, Jelena, Schumacher, Katja, Dinov, Borislav, Kosich, Falco, Sommer, Philipp, Arya, Arash, Husser, Daniela, Bollmann, Andreas, Lip, Gregory YH 
ORCID: 0000-0002-7566-1626 and Hindricks, Gerhard
(2018)
Prediction of electro-anatomical substrate and arrhythmia recurrences using APPLE, DR-FLASH and MB-LATER scores in patients with atrial fibrillation undergoing catheter ablation.
SCIENTIFIC REPORTS, 8 (1).
12686-.
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Prediction of electro-anatomical substrate and arrhythmia recurrences using APPLE, DR-FLASH and MB-LATER scores in patients with atrial fibrillation undergoing catheter ablation.pdf - Published version Download (1MB) | Preview |
Abstract
Arrhythmia recurrences after catheter ablation of atrial fibrillation (AF) cause intensive treatment costs. Left atrial electro-anatomical remodeling measured as low voltage areas (LVA) during catheter ablation indicates advanced disease stage and is associated with poor ablation success. The aim of this study was to analyze the prediction of LVA and arrhythmia recurrences using APPLE, DR-FLASH and MB-LATER scores. APPLE, DR-FLASH scores were calculated at baseline and MB-LATER at 3 months post-ablation in AF patients undergoing first catheter ablation. LVA was determined using high-density maps and defined as <0.5 mV. Early (ERAF, <3 months) and late (LRAF, 3-12 months) were analyzed during follow-up. The study population included 241 patients (age 64 ± 11 years, 59% males, 59% persistent AF, 27% LVA, 27% LRAF). LVA were significantly associated with recurrences (OR 2.081, p = 0.026). While on univariable analysis, all scores were significantly associated with LVA, on multivariable analysis only APPLE (OR 1.789, p < 0.001) and DR-FLASH (OR 2.144, p < 0.001) remained significant predictors. However, MB-LATER (OR 1.445, p = 0.034) and ERAF (OR 5.078, p < 0.001) remained associated with LRAF on the multivariable analysis. These results were validated in a subgroup of 873 patients (age 61 ± 10, 63% males, 39% persistent AF, 34% LRAF, 27% LVA) from The Leipzig Heart Center AF Ablation Registry. All scores were significantly associated with recurrences. However, ERAF was the most powerful predictor for later rhythm outcomes. Summarizing, a clinical score useful for prediction for both LVA and rhythm outcomes in AF patients remains a clinical unmet need.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans, Atrial Fibrillation, Catheter Ablation, Multivariate Analysis, Risk Factors, Retrospective Studies, Aged, Middle Aged, Female, Male, Arrhythmias, Cardiac, Atrial Remodeling |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 17 May 2019 09:19 |
| Last Modified: | 19 Jan 2023 00:45 |
| DOI: | 10.1038/s41598-018-31133-x |
| Open Access URL: | https://doi.org/10.1038/s41598-018-31133-x |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3041740 |
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