Validation of the MB-LATER score for prediction of late recurrence after catheter-ablation of atrial fibrillation

Tatjana S. Potpara, Nebojsa Mujovic, Bhradeev Sivasambu, Alena Shantsila, Milan Marinkovic, Hugh Calkins, David D Spragg, Gregory Y.H. Lip

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalInternational Journal of Cardiology
DOIs
StateAccepted/In press - Jan 1 2018

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Catheter Ablation
Atrial Fibrillation
Recurrence
Aptitude
Baltimore
Anti-Arrhythmia Agents
Patient Selection
Area Under Curve
Decision Making
Communication
Survival

Keywords

  • AF recurrence post-ablation
  • Catheter-ablation of AF
  • MB-LATER score
  • Risk assessment

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Validation of the MB-LATER score for prediction of late recurrence after catheter-ablation of atrial fibrillation. / Potpara, Tatjana S.; Mujovic, Nebojsa; Sivasambu, Bhradeev; Shantsila, Alena; Marinkovic, Milan; Calkins, Hugh; Spragg, David D; Lip, Gregory Y.H.

In: International Journal of Cardiology, 01.01.2018.

Research output: Contribution to journalArticle

Potpara, Tatjana S. ; Mujovic, Nebojsa ; Sivasambu, Bhradeev ; Shantsila, Alena ; Marinkovic, Milan ; Calkins, Hugh ; Spragg, David D ; Lip, Gregory Y.H. / Validation of the MB-LATER score for prediction of late recurrence after catheter-ablation of atrial fibrillation. In: International Journal of Cardiology. 2018.
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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.",
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T1 - Validation of the MB-LATER score for prediction of late recurrence after catheter-ablation of atrial fibrillation

AU - Potpara, Tatjana S.

AU - Mujovic, Nebojsa

AU - Sivasambu, Bhradeev

AU - Shantsila, Alena

AU - Marinkovic, Milan

AU - Calkins, Hugh

AU - Spragg, David D

AU - Lip, Gregory Y.H.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - AF recurrence post-ablation

KW - Catheter-ablation of AF

KW - MB-LATER score

KW - Risk assessment

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