Renal Dysfunction, Stroke Risk Scores (CHADS2, CHA2DS2-VASc and R2CHADS2) and the Risk of Thromboembolic Events after Catheter Ablation of Atrial Fibrillation: The Leipzig Heart Center AF Ablation Registry

AHA: CIRCEP: September 18, 2013

Background—There are limited data on the predictive value of stroke risk scores for thromboembolic events (TE) after catheter ablation of atrial fibrillation (AF). Our objectives were to report the incidence of TE after AF ablation in a large contemporary AF ablation cohort.

Methods and Results—Using the Leipzig Heart Center AF Ablation Registry, we documented TE in patients undergoing radiofrequency AF catheter ablation. TE was defined as stroke, transient ischaemic attack (TIA) or systemic embolism. Study population (n=2,069, 66% male, 60±10 years; 62% paroxysmal AF; mean CHADS₂ 1.2 ± 0.9, CHA₂DS₂-VASc 2.1 ± 1.4 and R₂CHADS₂ 1.3 ± 1.1) were followed-up for a median 18 [Q1-to-Q3 12-29] months (i.e. 3.078 patient-years). Overall 31 TE occurred, with 16 events within 30 days of ablation and 15 TE (0.72%) during the follow-up period. On multivariate analysis, CHADS₂ (p<0.001), R₂CHADS₂(p<0.001), CHA₂DS₂-VASc (p=0.003) scores were independent predictors of TE during follow-up and AF recurrence conferred a non-significant trend for increased TE risk (p=0.071 – 0.094).  Read more