Predictors of arrhythmia recurrence after balloon cryoablation of atrial fibrillation: the value of CAAP-AF risk scoring system

Research output: Contribution to journalArticle

Abstract

Purpose: In the present study, we aimed to test the value of CAAP-AF score for prediction of atrial fibrillation (AF) recurrence at follow-up in a group of our patients treated by balloon cryoablation. Methods: A total of 283 symptomatic drug-refractory AF patients [261 (92%) with paroxysmal AF] who underwent pulmonary vein isolation (PVI) with second-generation cryoballoon between April 2012 and October 2016 were included. The CAAP-AF score was calculated for every patient. Results: A total of 283 patients [68 female (20%), mean age 59.8 ± 11.4 years] were included in the present analysis. Eighty-nine patients (31%) had hypertension and 13 (4%) had coronary artery disease. The mean left atrial diameter and left ventricular ejection fraction were 40.6 ± 7.0 mm and 60.0 ± 9.1%, respectively. The mean CHA2DS2-VASc score was 1.2 ± 1.1, and mean number of prior failed antiarrhythmic drugs was 1.4 ± 0.8. At 18 ± 6 months follow-up, 25 patients (8.87%) developed AF recurrence. The recurrence rate was as follows: 3.17% (score 0–3), 8.47% (score 4), 16.28% (score 5), 6.67% (score 6), 23.08% (score 7), and 36.36% (score ≥8). The recurrence rate was 4.86% at a score <5 and 16.49% at a value ≥5; a score cutoff ≥5 predicted AF recurrence with a sensitivity 64% and specificity 68%. Conclusions: The present analysis suggests the usefulness of CAAP-AF scoring system, with its simple and easily obtained six clinical variables, to predict AF recurrence after PVI by means of second-generation cryoballoon. A score value ≥5 predicted AF recurrence with a sensitivity 64% and specificity 68%.

Original languageEnglish
Pages (from-to)129-135
Number of pages7
JournalJournal of Interventional Cardiac Electrophysiology
Volume49
Issue number2
DOIs
Publication statusPublished - Aug 1 2017

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Cryosurgery
Atrial Fibrillation
Cardiac Arrhythmias
Recurrence
Pulmonary Veins
Sensitivity and Specificity
Anti-Arrhythmia Agents
Stroke Volume
Coronary Artery Disease
Hypertension

Keywords

  • Atrial fibrillation
  • CAAP-AF score
  • Cryoballoon ablation
  • Predictors of recurrence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

@article{f81f7fee705e46c6980e48b34b85d18d,
title = "Predictors of arrhythmia recurrence after balloon cryoablation of atrial fibrillation: the value of CAAP-AF risk scoring system",
abstract = "Purpose: In the present study, we aimed to test the value of CAAP-AF score for prediction of atrial fibrillation (AF) recurrence at follow-up in a group of our patients treated by balloon cryoablation. Methods: A total of 283 symptomatic drug-refractory AF patients [261 (92{\%}) with paroxysmal AF] who underwent pulmonary vein isolation (PVI) with second-generation cryoballoon between April 2012 and October 2016 were included. The CAAP-AF score was calculated for every patient. Results: A total of 283 patients [68 female (20{\%}), mean age 59.8 ± 11.4 years] were included in the present analysis. Eighty-nine patients (31{\%}) had hypertension and 13 (4{\%}) had coronary artery disease. The mean left atrial diameter and left ventricular ejection fraction were 40.6 ± 7.0 mm and 60.0 ± 9.1{\%}, respectively. The mean CHA2DS2-VASc score was 1.2 ± 1.1, and mean number of prior failed antiarrhythmic drugs was 1.4 ± 0.8. At 18 ± 6 months follow-up, 25 patients (8.87{\%}) developed AF recurrence. The recurrence rate was as follows: 3.17{\%} (score 0–3), 8.47{\%} (score 4), 16.28{\%} (score 5), 6.67{\%} (score 6), 23.08{\%} (score 7), and 36.36{\%} (score ≥8). The recurrence rate was 4.86{\%} at a score <5 and 16.49{\%} at a value ≥5; a score cutoff ≥5 predicted AF recurrence with a sensitivity 64{\%} and specificity 68{\%}. Conclusions: The present analysis suggests the usefulness of CAAP-AF scoring system, with its simple and easily obtained six clinical variables, to predict AF recurrence after PVI by means of second-generation cryoballoon. A score value ≥5 predicted AF recurrence with a sensitivity 64{\%} and specificity 68{\%}.",
keywords = "Atrial fibrillation, CAAP-AF score, Cryoballoon ablation, Predictors of recurrence",
author = "Mohamed Sanhoury and Massimo Moltrasio and Fabrizio Tundo and Stefania Riva and {Dello Russo}, Antonio and Michela Casella and Claudio Tondo and Gaetano Fassini",
year = "2017",
month = "8",
day = "1",
doi = "10.1007/s10840-017-0248-4",
language = "English",
volume = "49",
pages = "129--135",
journal = "Journal of Interventional Cardiac Electrophysiology",
issn = "1383-875X",
publisher = "Springer Netherlands",
number = "2",

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TY - JOUR

T1 - Predictors of arrhythmia recurrence after balloon cryoablation of atrial fibrillation

T2 - the value of CAAP-AF risk scoring system

AU - Sanhoury, Mohamed

AU - Moltrasio, Massimo

AU - Tundo, Fabrizio

AU - Riva, Stefania

AU - Dello Russo, Antonio

AU - Casella, Michela

AU - Tondo, Claudio

AU - Fassini, Gaetano

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Purpose: In the present study, we aimed to test the value of CAAP-AF score for prediction of atrial fibrillation (AF) recurrence at follow-up in a group of our patients treated by balloon cryoablation. Methods: A total of 283 symptomatic drug-refractory AF patients [261 (92%) with paroxysmal AF] who underwent pulmonary vein isolation (PVI) with second-generation cryoballoon between April 2012 and October 2016 were included. The CAAP-AF score was calculated for every patient. Results: A total of 283 patients [68 female (20%), mean age 59.8 ± 11.4 years] were included in the present analysis. Eighty-nine patients (31%) had hypertension and 13 (4%) had coronary artery disease. The mean left atrial diameter and left ventricular ejection fraction were 40.6 ± 7.0 mm and 60.0 ± 9.1%, respectively. The mean CHA2DS2-VASc score was 1.2 ± 1.1, and mean number of prior failed antiarrhythmic drugs was 1.4 ± 0.8. At 18 ± 6 months follow-up, 25 patients (8.87%) developed AF recurrence. The recurrence rate was as follows: 3.17% (score 0–3), 8.47% (score 4), 16.28% (score 5), 6.67% (score 6), 23.08% (score 7), and 36.36% (score ≥8). The recurrence rate was 4.86% at a score <5 and 16.49% at a value ≥5; a score cutoff ≥5 predicted AF recurrence with a sensitivity 64% and specificity 68%. Conclusions: The present analysis suggests the usefulness of CAAP-AF scoring system, with its simple and easily obtained six clinical variables, to predict AF recurrence after PVI by means of second-generation cryoballoon. A score value ≥5 predicted AF recurrence with a sensitivity 64% and specificity 68%.

AB - Purpose: In the present study, we aimed to test the value of CAAP-AF score for prediction of atrial fibrillation (AF) recurrence at follow-up in a group of our patients treated by balloon cryoablation. Methods: A total of 283 symptomatic drug-refractory AF patients [261 (92%) with paroxysmal AF] who underwent pulmonary vein isolation (PVI) with second-generation cryoballoon between April 2012 and October 2016 were included. The CAAP-AF score was calculated for every patient. Results: A total of 283 patients [68 female (20%), mean age 59.8 ± 11.4 years] were included in the present analysis. Eighty-nine patients (31%) had hypertension and 13 (4%) had coronary artery disease. The mean left atrial diameter and left ventricular ejection fraction were 40.6 ± 7.0 mm and 60.0 ± 9.1%, respectively. The mean CHA2DS2-VASc score was 1.2 ± 1.1, and mean number of prior failed antiarrhythmic drugs was 1.4 ± 0.8. At 18 ± 6 months follow-up, 25 patients (8.87%) developed AF recurrence. The recurrence rate was as follows: 3.17% (score 0–3), 8.47% (score 4), 16.28% (score 5), 6.67% (score 6), 23.08% (score 7), and 36.36% (score ≥8). The recurrence rate was 4.86% at a score <5 and 16.49% at a value ≥5; a score cutoff ≥5 predicted AF recurrence with a sensitivity 64% and specificity 68%. Conclusions: The present analysis suggests the usefulness of CAAP-AF scoring system, with its simple and easily obtained six clinical variables, to predict AF recurrence after PVI by means of second-generation cryoballoon. A score value ≥5 predicted AF recurrence with a sensitivity 64% and specificity 68%.

KW - Atrial fibrillation

KW - CAAP-AF score

KW - Cryoballoon ablation

KW - Predictors of recurrence

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U2 - 10.1007/s10840-017-0248-4

DO - 10.1007/s10840-017-0248-4

M3 - Article

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JO - Journal of Interventional Cardiac Electrophysiology

JF - Journal of Interventional Cardiac Electrophysiology

SN - 1383-875X

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