Development and Validation of a Novel Prognostic Tool to Predict Recurrence of Paroxysmal Atrial Fibrillation after the First-Time Catheter Ablation: A Retrospective Cohort Study
There is no gold standard to tell frustrating outcomes after the catheter ablation of paroxysmal atrial fibrillation (PAF). The study aims to construct a prognostic tool. We retrospectively analyzed 315 patients with PAF who underwent first-time ablation at the Second Xiangya Hospital of Central Sou...
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MDPI AG
2023-03-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/6/1207 |
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| author | Junjie Huang Hao Chen Quan Zhang Rukai Yang Shuai Peng Zhijian Wu Na Liu Liang Tang Zhenjiang Liu Shenghua Zhou |
| author_facet | Junjie Huang Hao Chen Quan Zhang Rukai Yang Shuai Peng Zhijian Wu Na Liu Liang Tang Zhenjiang Liu Shenghua Zhou |
| author_sort | Junjie Huang |
| collection | DOAJ |
| description | There is no gold standard to tell frustrating outcomes after the catheter ablation of paroxysmal atrial fibrillation (PAF). The study aims to construct a prognostic tool. We retrospectively analyzed 315 patients with PAF who underwent first-time ablation at the Second Xiangya Hospital of Central South University. The endpoint was identified as any documented relapse of atrial tachyarrhythmia lasting longer than 30 s after the three-month blanking period. Univariate Cox regression analyzed eleven preablation parameters, followed by two supervised machine learning algorithms and stepwise regression to construct a nomogram internally validated. Five factors related to ablation failure were as follows: female sex, left atrial appendage emptying flow velocity ≤31 cm/s, estimated glomerular filtration rate <65.8 mL/(min·1.73 m<sup>2</sup>), P wave duration in lead aVF ≥ 120 ms, and that in lead V1 ≥ 100 ms, which constructed a nomogram. It was correlated with the CHA<sub>2</sub>DS<sub>2</sub>-VASc score but outperformed the latter evidently in discrimination and clinical utility, not to mention its robust performances in goodness-of-fit and calibration. In addition, the nomogram-based risk stratification could effectively separate ablation outcomes. Patients at risk of relapse after PAF ablation can be recognized at baseline using the proposed five-factor nomogram. |
| first_indexed | 2024-03-11T06:40:32Z |
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| id | doaj.art-1523a2ae468840ce80f70307897bcbab |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T06:40:32Z |
| publishDate | 2023-03-01 |
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| series | Diagnostics |
| spelling | doaj.art-1523a2ae468840ce80f70307897bcbab2023-11-17T10:35:49ZengMDPI AGDiagnostics2075-44182023-03-01136120710.3390/diagnostics13061207Development and Validation of a Novel Prognostic Tool to Predict Recurrence of Paroxysmal Atrial Fibrillation after the First-Time Catheter Ablation: A Retrospective Cohort StudyJunjie Huang0Hao Chen1Quan Zhang2Rukai Yang3Shuai Peng4Zhijian Wu5Na Liu6Liang Tang7Zhenjiang Liu8Shenghua Zhou9Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410011, ChinaDepartment of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410011, ChinaDepartment of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410011, ChinaDepartment of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410011, ChinaDepartment of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410011, ChinaDepartment of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410011, ChinaDepartment of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410011, ChinaDepartment of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410011, ChinaDepartment of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410011, ChinaDepartment of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410011, ChinaThere is no gold standard to tell frustrating outcomes after the catheter ablation of paroxysmal atrial fibrillation (PAF). The study aims to construct a prognostic tool. We retrospectively analyzed 315 patients with PAF who underwent first-time ablation at the Second Xiangya Hospital of Central South University. The endpoint was identified as any documented relapse of atrial tachyarrhythmia lasting longer than 30 s after the three-month blanking period. Univariate Cox regression analyzed eleven preablation parameters, followed by two supervised machine learning algorithms and stepwise regression to construct a nomogram internally validated. Five factors related to ablation failure were as follows: female sex, left atrial appendage emptying flow velocity ≤31 cm/s, estimated glomerular filtration rate <65.8 mL/(min·1.73 m<sup>2</sup>), P wave duration in lead aVF ≥ 120 ms, and that in lead V1 ≥ 100 ms, which constructed a nomogram. It was correlated with the CHA<sub>2</sub>DS<sub>2</sub>-VASc score but outperformed the latter evidently in discrimination and clinical utility, not to mention its robust performances in goodness-of-fit and calibration. In addition, the nomogram-based risk stratification could effectively separate ablation outcomes. Patients at risk of relapse after PAF ablation can be recognized at baseline using the proposed five-factor nomogram.https://www.mdpi.com/2075-4418/13/6/1207paroxysmal atrial fibrillationcatheter ablationrecurrenceprediction modelprognostic toolnomogram |
| spellingShingle | Junjie Huang Hao Chen Quan Zhang Rukai Yang Shuai Peng Zhijian Wu Na Liu Liang Tang Zhenjiang Liu Shenghua Zhou Development and Validation of a Novel Prognostic Tool to Predict Recurrence of Paroxysmal Atrial Fibrillation after the First-Time Catheter Ablation: A Retrospective Cohort Study Diagnostics paroxysmal atrial fibrillation catheter ablation recurrence prediction model prognostic tool nomogram |
| title | Development and Validation of a Novel Prognostic Tool to Predict Recurrence of Paroxysmal Atrial Fibrillation after the First-Time Catheter Ablation: A Retrospective Cohort Study |
| title_full | Development and Validation of a Novel Prognostic Tool to Predict Recurrence of Paroxysmal Atrial Fibrillation after the First-Time Catheter Ablation: A Retrospective Cohort Study |
| title_fullStr | Development and Validation of a Novel Prognostic Tool to Predict Recurrence of Paroxysmal Atrial Fibrillation after the First-Time Catheter Ablation: A Retrospective Cohort Study |
| title_full_unstemmed | Development and Validation of a Novel Prognostic Tool to Predict Recurrence of Paroxysmal Atrial Fibrillation after the First-Time Catheter Ablation: A Retrospective Cohort Study |
| title_short | Development and Validation of a Novel Prognostic Tool to Predict Recurrence of Paroxysmal Atrial Fibrillation after the First-Time Catheter Ablation: A Retrospective Cohort Study |
| title_sort | development and validation of a novel prognostic tool to predict recurrence of paroxysmal atrial fibrillation after the first time catheter ablation a retrospective cohort study |
| topic | paroxysmal atrial fibrillation catheter ablation recurrence prediction model prognostic tool nomogram |
| url | https://www.mdpi.com/2075-4418/13/6/1207 |
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