Using the MB-LATER score for predicting arrhythmia outcome after catheter ablation for atrial fibrillation: The Guangzhou atrial fibrillation project.

INTRODUCTION: Several clinical scoring systems have been derived to predict the arrhythmia outcome of catheter ablation (CA) for atrial fibrillation (AF) but which is better is not clear. Simple clinical risk scores (that any clinician can use in the everyday clinic) can help assess the likelihood of recurrence of AF following CA and the simple MB-LATER score has recently been described. We compare the predictive ability of seven existing clinical scoring systems (HATCH, CHADS2 , CHA2 DS2 -VASc, BASE-AF2 , APPLE, CAAP-AF, and MB-LATER) in a Chinese cohort of AF patients undergoing CA.

METHODS AND RESULTS: 1410 patients (mean age 57.2 ± 11.6 years; 68% male) with AF undergoing CA during 2011-2015 were enrolled in final analysis. Symptoms, 12 lead ECG and Holter ECGs were recorded before discharge, and at 1, 3, 6 months, and every 6 months thereafter to detect the arrhythmia relapse. During a mean 20.7 ± 8.8-month follow-up, recurrence occurred in 365 patients(25.9%). All tested scores were predictors of AF recurrence with areas under the curve (AUCs) of 0.58, 0.57, 0.57, 0.75, 0.74, 0.71, and 0.73 respectively (all P < 0.01). Compared to all other scores, the MB-LATER score showed improved reclassification (NRI range 30%-82.6%, P < 0.01) and discrimination indexes (IDI range 2.6%-18.6%, all P < 0.01) in predicting AF recurrence.

CONCLUSION: Based on net reclassification and discrimination analysis, the MB-LATER score performed best for predicting AF recurrent postablation, in a large "all comers" Chinese cohort. This simple clinical risk score (that any clinician can use in the everyday clinic) can help assess the likelihood of recurrence of AF following catheter ablation.