CHADS2 and CHA2DS2-VASc scores as predictors of left atrial ablation outcomes for paroxysmal atrial fibrillation

The selection of patients with atrial fibrillation (AF) that will benefit most by left atrial ablation remains suboptimal. CHADS(2) score has been shown to be associated with post-ablation AF recurrences. However, data regarding the CHA(2)DS(2)-VASc score are lacking. In addition, there is paucity of data regarding the exact predictive value, in terms of sensitivity and specificity, of each of these scores as to AF recurrence. This study aimed to evaluate the merit of the CHADS(2) and CHA(2)DS(2)-VASc scores in predicting arrhythmia recurrence after a single ablation procedure for paroxysmal AF. One hundred and twenty-six patients (78 males, median age 61 years) with symptomatic paroxysmal AF underwent left atrial ablation. Over 16 months (interquartile range: 10.826.0), 89 patients were recurrence-free (70.6). Larger left atrial volume (P: 0.039), diabetes (P: 0.001), dyslipidemia (P: 0.003), coronary artery disease (P: 0.003), class III antiarrhythmic drugs (P: 0.017), CHADS(2) (P: 0.006), and CHA(2)DS(2)-VASc (P: 0.016) scores were univariately associated with recurrence. In the multivariate analysis, both CHADS(2) (hazard ratio: 1.91, 95 confidence interval 1.093.36, P: 0.023) and CHA(2)DS(2)-VASc (hazard ratio: 1.97, 95 confidence interval 1.163.33, P: 0.012) were independently associated with AF recurrence. Cut-off analysis showed that a score 2 for both the CHADS(2) (sensitivity 46 and specificity 79, area under the Receivers operating characteristic curve, AUC 0.644) and CHA(2)DS(2)-VASc score (sensitivity 57 and specificity 65, AUC 0.627) showed the highest predictive value for AF recurrence. CHA(2)DS(2)-VASc score is an independent predictor of left atrial ablation outcomes for paroxysmal AF, with a similar predictive value to CHADS(2). However, the predictive accuracy of both is mediocre.