A novel score in the prediction of rhythm outcome after ablation of atrial fibrillation: The SUCCESS score

Özet

Objective: The aim of the present study was to assess the predictive value of the CHADS2, CHA2DS2-VASc, R2CHADS2, and APPLE scores forrhythm outcome in patients with atrial fibrillation (AF) after catheter ablation.Methods: The cohort of the present study consisted of 192 patients with AF who underwent a total of 265 ablations. Rhythm outcome was documented between 3 and 24 month after ablation. The mentioned scores were calculated for every patient.Results: Of the patients, 139 (72%) were successfully treated having freedom of any atrial tachyarrhythmia, whereas 21 (11%) had partial success, and 32 (17%) had failure. For univariate analysis, the APPLE score was the only significant predictor of outcome after ablation with an oddsratio (OR) of 1.485 [95% confidence interval (CI) 1.075–2.052, p-value 0.017]. A multivariate binary regression corrected for possible confounders showed that the APPLE score (OR 1.527, 95% CI 1.082–2.153, p-value 0.016) along with the number of previous ablations (OR 5.831, 95% CI1.356–25.066, p-value 0.018) is a significant predictor of outcome. A novel score (SUCCESS) was created by adding one point to the APPLE scorefor each previously performed ablation. This novel score demonstrated an improvement in receiver operating characteristic curve analysis (areaunder the curve 0.657 vs. 0.620). However, these findings were not significant in our study (p-value 0.219).Conclusion: Both the APPLE and the novel SUCCESS scores are superior to the CHADS2, CHA2DS2-VASc, and R2CHADS2 scores in predicting AFrecurrence after catheter ablation. The SUCCESS score appears to have a higher predictive value than the APPLE score and might be a valuabletool to estimate the risk of AF recurrence in patients eligible for catheter ablation. (Anatol J Cardiol 2019; 21: 142-9)