Novel risk score for predicting recurrence of atrial fibrillation after the Cryo-Maze procedure. (7th February 2021)

• Record Type: Journal Article
• Authors: Kakuta, Takashi; Fukushima, Satsuki; Minami, Kimito; Saito, Tetsuya; Kawamoto, Naonori; Tadokoro, Naoki; Ikuta, Ayumi; Kobayashi, Junjiro; Fujita, Tomoyuki
• Is Part Of: European journal of cardio-thoracic surgery. Volume 59:Number 6(2021)
• Page Start: 1218
• Page End: 1225
• Publication Date: 2021-02-07
• Subjects: Atrial fibrillation -- Cryo-Maze procedure -- Risk score model; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; 617.54
• DOI: 10.1093/ejcts/ezaa468
• Languages: English
• ISSNs: 1010-7940

Abstract

Abstract: : OBJECTIVES: This study aimed to develop a novel risk score model for quantitative prediction of the rate of atrial fibrillation (AF) recurrence after the Cryo-Maze procedure in patients with persistent AF. METHODS: We enrolled 450 consecutive patients who underwent the Cryo-Maze procedure for persistent AF concomitant with other cardiac procedures in our institute between 2001 and 2019. We randomly divided the cohort into two groups. We derived a model in a 'development cohort' (270 patients; 60%) and validated it in a 'test cohort' (180 patients; 40%) by receiver operating characteristic curve analysis. RESULTS: The median follow-up was 5.2 (interquartile range: 2.0–9.9) years. The 1-, 5-, 10- and 15-year rates of freedom from AF recurrence in the entire cohort were 91.4%, 83.5%, 76.2% and 57.1%, respectively. Risk factors for AF recurrence examined by logistic regression analysis included F-wave voltage in V1 < 0.2 mV, preoperative AF duration >5 years and left atrial volume index >100 ml/m 2 . Points were assigned to each risk factor according to its odds ratio. A novel risk score model was developed using these three variables and age, with a range up to 10 points. High score (>7) predicted high rates of AF recurrence after the Cryo-Maze procedure. The area under the receiver operating characteristic curve of the novel risk model score was 0.78 (95% confidence interval: 0.65–0.91) in the test cohort. CONCLUSIONS: Use of the Cryo-Maze procedure should be carefully considered in patients with a higher model score because of a higher risk of AF recurrence.