Validation of the MB-LATER score for prediction of late recurrence after catheter-ablation of atrial fibrillation. (1st February 2019)

• Record Type: Journal Article
• Authors: Potpara, Tatjana S.; Mujovic, Nebojsa; Sivasambu, Bhradeev; Shantsila, Alena; Marinkovic, Milan; Calkins, Hugh; Spragg, David; Lip, Gregory Y.H.
• Is Part Of: International journal of cardiology. Volume 276(2019)
• Page Start: 130
• Page End: 135
• Publication Date: 2019-02-01
• Subjects: AF recurrence post-ablation -- Catheter-ablation of AF -- MB-LATER score -- Risk assessment; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2018.08.018
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Reliable identification of atrial fibrillation (AF) patients more likely to be AF-free long-term post-single catheter ablation (CA) would facilitate appropriate risk communication to patients. We validated the recently proposed MB-LATER score for prediction of late recurrences of AF (LRAF) post-CA. Methods: Patients who underwent CA for symptomatic AF refractory to ≥1 antiarrhythmic drugs at the Johns Hopkins Hospital, Baltimore, between March 2003 and December 2015, for whom ≥1-year post-CA follow-up data were available, were enrolled. Results: Of 226 patients (median age 58.5 years [IQR: 52.0–65.0], 163 males [72.1%], 142 [62.8%] with paroxysmal AF), LRAF occurred in 133 patients (58.8%) during a median 2-year follow-up (IQR: 1.1–4.1). The mean MB-LATER score was significantly higher in patients with versus those without LRAF (2.4 ± 1.2 vs. 1.9 ± 1.3, p = 0.002) and showed modest but significant predictive ability for LRAF (AUC: 0.62 [95% CI: 0.54–0.69], p = 0.003). A score cut-off value of >2 showed the best predictive ability for LRAF (70.4% [61.5–77.9]), with modest sensitivity (42.9% [34.3–51.7]) and specificity (74.2% [64.1–82.7]). Kaplan-Meyer survival free from AF was significantly better for patients with a MB-LATER score of ≤2 than for those with a score of >2 (log-rank p = 0.005). Conclusion: In our study, the MB-LATER score showed a significant but modest predictive ability for LRAF post-AF ablation. Further prospective validation is needed to better define the potential role of the MB-LATER score in patient selection and treatment decision-making post-AF ablation. Highlights: This study is the first external validation of the MB-LATER score for prediction of late AF recurrence post AF ablation. The use of clinical variables-based MB-LATER score could help in the risk communication to patients, shared decision-making and treatment decisions post AF ablation.