A prediction model of atrial fibrillation recurrence after first catheter ablation by a nomogram: HASBLP score

Wenqiang Han; Yan Liu; Rina Sha; Huiyu Liu; Aihua Liu; Kellina Maduray; Junye Ge; Chuanzhen Ma; Jingquan Zhong

doi:10.3389/fcvm.2022.934664

A prediction model of atrial fibrillation recurrence after first catheter ablation by a nomogram: HASBLP score

Front Cardiovasc Med. 2022 Sep 6:9:934664. doi: 10.3389/fcvm.2022.934664. eCollection 2022.

Authors

Wenqiang Han¹, Yan Liu¹, Rina Sha¹, Huiyu Liu¹, Aihua Liu¹, Kellina Maduray¹, Junye Ge¹, Chuanzhen Ma¹, Jingquan Zhong^{1

2}

Affiliations

¹ Department of Cardiology, The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
² Department of Cardiology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China.

Abstract

Background: At present, catheter ablation is an effective method for rhythm control in patients with atrial fibrillation (AF). However, AF recurrence is an inevitable problem after catheter ablation. To identify patients who are prone to relapse, we developed a predictive model that allows clinicians to closely monitor these patients and treat them with different personalized treatment plans.

Materials and methods: A total of 1,065 patients who underwent AF catheter ablation between January 2015 and December 2018 were consecutively included in this study, which examines the results of a 2-year follow-up. Patients with AF were divided into development cohort and validation cohort. Univariate and multivariate analyses were carried out on the potential risk factors. Specific risk factors were used to draw the nomogram according to the above results. Finally, we verified the performance of our model compared with CHADS2 and CHA₂DS₂-Vasc scores by receiver operating characteristic (ROC) curve and calibration curve and plotted the decision analysis curve (DAC).

Results: A total of 316 patients experienced AF recurrence. After univariate and multivariate analyses, AF history (H), age (A), snoring (S), body mass index (BMI) (B), anteroposterior diameter of left atrial (LA) (L), and persistent AF (P) were included in our prediction model. Our model showed a better performance compared with CHADS2 and CHA2DS2-Vasc scores, and the area under ROC curve (95%CI) was 0.7668 (0.7298-0.8037) vs. 0.6225 (0.5783-0.6666) and 0.6267 (0.5836-0.6717).

Conclusion: We established a nomogram (HASBLP score) for predicting AF recurrence after the first catheter ablation at a 2-year follow-up, which can be used as a tool to guide future follow-up of patients. However, its usefulness needs further validation.

Keywords: atrial fibrillation; catheter ablation; nomogram; prediction model; recurrence.