51. Evaluation of predictive scores for late and very late recurrence after cryoballoon-based ablation of atrial fibrillation
- Author
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Makoto Sano, Julia Vogler, Christian-Hendrik Heeger, Ben Brüggemann, Niels Große, Ahmad Keelani, Spyridon Liosis, Roland Richard Tilz, Behzad Hassan Hosseiny Fahimi, Charlotte Eitel, Huong Lan Phan, Thomas Fink, Samuel Reincke, and Vanessa Sciacca
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medicine.medical_specialty ,Ablation of atrial fibrillation ,Late recurrence ,030204 cardiovascular system & hematology ,Cryosurgery ,Article ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Physiology (medical) ,Internal medicine ,Late Recurrence ,medicine ,Humans ,Sinus rhythm ,030212 general & internal medicine ,Cryoballoon ablation ,Retrospective Studies ,business.industry ,Area under the curve ,Atrial fibrillation ,medicine.disease ,Predictive value ,Treatment Outcome ,Pulmonary Veins ,Cohort ,Catheter Ablation ,Cardiology ,MB-LATER score ,Cardiology and Cardiovascular Medicine ,business ,Very late recurrence - Abstract
Purpose Studies on predictive scores for very late recurrence (VLR) (recurrence later than 12 months) after second-generation cryoballoon-based pulmonary vein isolation (CB2-PVI) are sparse. We aimed to evaluate the frequency of late recurrence (LR) (later than 3 months) and VLR, and to validate predictive scores for LR and VLR after initial CB2-PVI. Methods A total of 288 patients undergoing initial CB2-PVI (66 ± 11 years, 46% paroxysmal) were retrospectively enrolled in the LR cohort. In the VLR cohort, 83 patients with recurrence within 3–12 months or with 2, ATLAS, SCALE-CryoAF, and MB-LATER scores. Results During a mean follow-up of 15.3 ± 7.1 months, 188 of 288 (65.2%) patients remained in sinus rhythm without any recurrences. Thirty-two of 205 (15.6%) patients experienced VLR after a mean of 16.6 ± 5.6 months. Comparing the predictive values of these specific scores, the MB-LATER score showed a reliable trend toward greater risk of both LR and VLR (area under the curve in LR; 0.632, 0.637, 0.632, 0.637, 0.604, 0.725, and 0.691 (p = ns), VLR; 0.612, 0.636, 0.644, 0.586, 0.541, 0.633, and 0.680 (p = 0.038, vs. BASE-AF2, respectively)). Kaplan-Meier analysis estimated patients with higher MB-LATER scores which had favorable outcomes (24-month freedom from LR; 26.0% vs. 56.7%, p p = 0.013). Conclusion The MB-LATER score provided more reliable predictive value for both LR and VLR. Patients with higher MB-LATER scores may benefit from more intensive long-term follow-up.
- Published
- 2020
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