CHA₂DS₂-VASc Score in the Prediction of Ischemic Stroke in Patients after Radiofrequency Catheter Ablation of Typical Atrial Flutter.
10.3349/ymj.2018.59.2.236
- Author:
Moo Nyun JIN
1
;
Changho SONG
;
Tae Hoon KIM
;
Jae Sun UHM
;
Hui Nam PAK
;
Moon Hyoung LEE
;
Boyoung JOUNG
Author Information
1. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea. cby6908@yuhs.ac
- Publication Type:Original Article
- Keywords:
Atrial flutter;
atrial fibrillation;
stroke;
catheter ablation;
CHA₂DS₂-VASc score
- MeSH:
Aged;
Aged, 80 and over;
Atrial Flutter/*surgery;
Brain Ischemia/epidemiology/*etiology;
Catheter Ablation/*adverse effects;
Female;
Follow-Up Studies;
Humans;
Incidence;
Middle Aged;
Postoperative Complications/*epidemiology;
Predictive Value of Tests;
Prognosis;
Proportional Hazards Models;
ROC Curve;
Risk Assessment/*methods;
Seoul/epidemiology;
Stroke/epidemiology/*etiology;
Treatment Outcome
- From:Yonsei Medical Journal
2018;59(2):236-242
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Despite undergoing successful catheter ablation of typical atrial flutter (AFL), patients remain at increased risk for ischemic stroke. However, data on risk prediction tools for the development of stroke after AFL ablation are lacking. This study investigates whether CHA₂DS₂-VASc score is useful for predicting ischemic stroke after successful ablation of typical AFL. MATERIALS AND METHODS: A total of 293 patients (236 men, mean age 56.1±13.5 years) who underwent successful radiofrequency catheter ablation for typical AFL were included in this study. The clinical end point was occurrence of ischemic stroke during follow-up after AFL ablation. RESULTS: During the follow-up period (60.8±45.9 months), ischemic stroke occurred in 18 (6%) patients at a median of 34 months (interquartile range, 13–65 months). CHA₂DS₂-VASc score [hazard ratio 2.104; 95% confidence interval (CI), 1.624–2.726; p < 0.001] was an independent predictor for the occurrence of stroke after AFL ablation. The area under the receiver operating characteristic curve for CHA₂DS₂-VASc score was 0.798 (95% CI, 0.691–0.904). The CHA₂DS₂-VASc score could be used to stratify patients into two groups with different incidences of ischemic stroke (1.6% vs. 14.4%, p < 0.001) at a cutoff value of 2. CONCLUSION: CHA₂DS₂-VASc score is useful in a prediction model for the risk of stroke after catheter ablation of typical AFL.
