Associations among the CHADS2 score, atrial substrate properties, and outcome of catheter ablation in patients with paroxysmal atrial fibrillation

被引：54

作者：

Chao, Tze-Fan ^{[1
,2
,3
]}

Cheng, Chen-Chuan ^{[4
]}

Lin, Wei-Shiang ^{[5
,6
]}

Tsao, Hsuan-Ming ^{[2
,3
,7
]}

Lin, Yenn-Jiang ^{[1
,2
,3
]}

Chang, Shih-Lin ^{[1
,2
,3
]}

Lo, Li-Wei ^{[1
,2
,3
]}

Hu, Yu-Feng ^{[1
,2
,3
]}

Tuan, Ta-Chuan ^{[1
,2
,3
]}

Suenari, Kazuyoshi ^{[1
,8
]}

Li, Cheng-Hung ^{[1
,2
,3
]}

Liu, Shuen-Hsin ^{[9
]}

Hartono, Beny ^{[1
]}

Wu, Tsu-Juey ^{[2
,3
,10
]}

Chen, Shih-Ann ^{[1
,2
,3
]}

机构：

[1] Taipei Vet Gen Hosp, Div Cardiol, Dept Med, Taipei, Taiwan

[2] Natl Yang Ming Univ, Inst Clin Med, Taipei, Taiwan

[3] Natl Yang Ming Univ, Cardiovasc Res Ctr, Taipei, Taiwan

[4] Chi Mei Med Ctr, Div Cardiol, Tainan, Taiwan

[5] Natl Def Med Ctr, Div Cardiol, Dept Internal Med, Taipei, Taiwan

[6] Triserv Gen Hosp, Taipei, Taiwan

[7] Natl Yang Ming Univ Hosp, Div Cardiol, Ilan, Taiwan

[8] Hiroshima Univ, Dept Cardiovasc Med, Grad Sch Biomed Sci, Hiroshima, Japan

[9] Taipei Med Univ Shuang Ho Hosp, Div Cardiol, Dept Med, Taipei, Taiwan

[10] Chung Shan Med Univ, Sch Med, Taichung, Taiwan

来源：

HEART RHYTHM | 2011年 / 8卷 / 08期

关键词：

Atrial fibrillation; CHADS(2) score; Substrate properties; Catheter ablation; Recurrence; STROKE; RECURRENCE; SAFETY;

D O I：

10.1016/j.hrthm.2011.03.016

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND The CHADS(2) score (congestive heart failure, hypertension, age > 75 years, diabetes, and previous stroke/transient ischemic attack) is used for the risk stratification of strokes in patients with atrial fibrillation (AF). OBJECTIVE This study aimed to investigate the associations between the CHADS(2) score, atrial substrate, and outcome of catheter ablation in patients with paroxysmal AF. METHODS A total of 247 paroxysmal AF patients who received catheter ablation were enrolled. The patients were divided into 3 groups according to their CHADS(2) score (group 1: score 0, group 2: score 1 to 2, and group 3: score 3 to 6). The bi-atrial substrate properties and outcome of catheter ablation were analyzed. RESULTS The CHADS(2) scores in these 3 groups were 0 (group 1), 1.24 +/- 0.48 (group 2), and 3.60 +/- 0.83 (group 3), respectively. The left atrial voltage became lower (group 1 vs. 2 vs. 3 = 2.08 +/- 0.73 mV vs. 1.80 +/- 0.81 mV vs. 1.06 +/- 0.69 mV) and the activation time longer (group 1 vs. 2 vs. 3 = 93.4 +/- 17.7 ms vs. 101.9 +/- 21.2 ms vs. 112.2 +/- 21.7 ms), whereas the CHADS(2) score increased. During a follow-up of 17.3 +/- 7.0 months, 23.1% of the study population suffered from recurrences. The recurrence rates of these 3 groups were 13.0% (group 1), 27.6% (group 2), and 45.9% (group 3), respectively. The groups of different CHADS(2) scores remained as the independent predictor of recurrence in the multivariate analysis. CONCLUSION A high CHADS(2) score was associated with different left atrial substrate properties and a poor outcome after catheter ablation of paroxysmal AF.

引用

页码：1155 / 1159

页数：5

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