CHA₂DS₂-VASc and SAMe-TT₂R₂ scores as predictors of recurrence for nonvalvular atrial fibrillation patients on vitamin K antagonists after radiofrequency catheter ablation

Abstract

Aims 

Atrial fibrillation is the most common sustained arrhythmia in the general population, and circumferential pulmonary vein isolation has emerged as a cornerstone in the treatment of drug-resistant atrial fibrillation. However, there is a paucity of data regarding the CHA₂DS₂-VASc and SAMe-TT₂R₂ scores as predictors of outcomes among patients with nonvalvular atrial fibrillation on vitamin K antagonists after radiofrequency catheter ablation (RFCA).

Methods 

The current prospective observational study enrolled 304 consecutive patients with atrial fibrillation who underwent RFCA. Warfarin was maintained for at least 3 months after RFCA. The 1-year atrial fibrillation recurrence rate was documented.

Results 

Persistent atrial fibrillation (P = 0.003), heart failure (P < 0.001), an enlarged left atrium (P = 0.003), current smoking (P < 0.001), the CHA₂DS₂-VASc score (P = 0.001), and the SAMe-TT₂R₂ score (P < 0.001) were univariate associated with recurrent atrial fibrillation. Cutoff analysis showed that a CHA₂DS₂-VASc score at least 3 (areas under the curve = 0.612; 95% confidence interval 0.537–0.687) and a SAMe-TT₂R₂ score at least 5 (areas under the curve = 0.642, 95% confidence interval 0.575–0.708) had the highest predictive value for atrial fibrillation recurrence. Patients with a CHA₂DS₂-VASc score at least 3 (P < 0.001) and a SAMe-TT₂R₂ score at least 5 (P = 0.001) had a higher probability of experiencing atrial fibrillation recurrence after RFCA compared with patients with a CHA₂DS₂-VASc score less than 3 and a SAMe-TT₂R₂ score less than 5.

Conclusion 

CHA₂DS₂-VASc and SAMe-TT₂R₂ scores were associated with 1-year recurrence of atrial fibrillation in patients on vitamin K antagonists after RFCA. For CHA₂DS₂-VASc and SAMe-TT₂R₂ scores, a cutoff value of at least 3 and at least 5 had the highest predictive value for atrial fibrillation recurrence, respectively.