Relationship between the CHADS2 score and risk of very late recurrences after catheter ablation of paroxysmal atrial fibrillation

Tze Fan Chao, Kibos Ambrose, Hsuan Ming Tsao, Yenn Jiang Lin, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Ta Chuan Tuan, Kazuyoshi Suenari, Cheng Hung Li, Beny Hartono, Hung Yu Chang, Tsu Juey Wu, Shih Ann Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

60 Scopus citations

Abstract

Background: Catheter ablation of paroxysmal atrial fibrillation has been performed for more than 10 years. However, data about the long-term results were limited. Objectives: To evaluate the long-tem efficacy following paroxysmal atrial fibrillation ablation and to investigate whether there were different patterns of recurrences in patients with different CHADS2 scores. Methods: A total of 238 patients with paroxysmal atrial fibrillation who received a catheter ablation from 2004 to 2007 were enrolled. Free of recurrence was defined as the absence of atrial arrhythmias without using any antiarrhythmic agents after ablation. Results: There were 121 patients (50.8%) suffering from recurrences after the first ablation procedure during a median follow-up period of 5 years. The CHADS2 score and left atrial diameter were significant predictors of recurrences in the multivariate analysis. Different patterns of recurrence were observed in different groups of patients categorized on the base of CHADS2 score. Among patients with a CHADS2 score of <3 without recurrences at 2 years postablation, 63.6% experienced episodes of arrhythmias during the subsequent follow-up period. In contrast, in patients with a CHADS2 score of 0 without recurrences at 2 years postablation, the future recurrence rate was only 2.7%. Conclusions: After a successful ablation, recurrences may continue to occur without reaching a plateau during the long-term follow-up, especially in patients with a high CHADS2 score. The optimal follow-up strategy may differ and should be individualized for patients with different scores.

Original languageEnglish
Pages (from-to)1185-1191
Number of pages7
JournalHeart Rhythm
Volume9
Issue number8
DOIs
StatePublished - Aug 2012

Keywords

  • Catheter ablation
  • Long-term outcome
  • Paroxysmal atrial fibrillation
  • Recurrence

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