| Objective: The purpose of this study was to investigate the risk of late recurrence in patients with atrial fibrillation(AF)after radiofrequency catheter ablation(RFCA),and to assess the ability of C2HEST and HATCH scores in predicting the risk of late recurrence at the same time.Method:261 patients who met the inclusion and exclusion criteria were finally included for analysis,all of them had atrial fibrillation and were performed for RFCA.Patients were grouped according to the C2HEST scores or HATCH scores,group 1 is score= 0,group 2 is score= 1,group 3 is score≥2,followup the patients every three months from 3 months to 12 months after RFCA through outpatient or telephone,recurrence of atrial fibrillation was the follow-up endpoint.Observed the patient’s late recurrence and record the time of recurrence based on follow-up.Statistical analysis was performed using SPSS25.0 software.Assess whether C2HEST and HATCH scores can be used as predictors of late recurrence after RFCA in patients with atrial fibrillation.The predictive ability of C2HEST and HATCH scores for atrial fibrillation recurrence was estimated by the area under the receiver operating characteristic curve(AUROC).The difference in receiver operating characteristic curve between the two models was compared using the De Long test.Results: Of the 261 patients included in the analysis,83(31.6%)patients suffered a late recurrence of atrial fibrillation after RFCA.The risk of postoperative recurrence of atrial fibrillation increased with increasing C2HEST or HATCH scores.Before adjusting for confounding factors,patients with C2HEST scores of 1,2,and 3group had Crude HR of 1.000(reference),5.304(95% CI,2.563-10.976),and 12.678(95% CI,6.089-26.396),respectively.After adjusting for confounding factors,the adjusted HR was 1.000(reference),4.284(95% CI,2.031-9.038),and 12.232(95% CI,5.697-26.259).Before adjusting for confounding factors,patients with HATCH scores of 1,2,and 3 group had Crude HR of 1.000(reference),2.651(95% CI,1.203-5.842)and 8.576(95% CI,4.370-16.831),after adjusting for the confounding factors,the adjusted HR was 1.000(reference),2.284(95% CI 4.01-4.810),and 6.991(95% CI3.454-14.150).The AUROC of C2HEST and HATCH scores in predicting postoperative recurrence of atrial fibrillation was 0.773(95%CI,0.713-0.833)and0.801(95% CI,0.740-0.861),respectively.There was no significant difference between the two models in their ability to evaluate patients for postoperative recurrence of atrial fibrillation(De Long test p-value = 0.36).Among the risk factors in both models,hypertension and heart failure(HF)contributed the most to postoperative recurrence after AF,higher blood pressure and lower cardiac ejection fraction(EF)were associated with a higher risk of recurrence.The Crude HR of LAD before adjusting confounders was 1.039(95% CI: 1.014-1.065,P=0.002),after adjusting for the confounders,the adjusted HR was1.045(95% CI: 1.017-1.075,P=0.002).The AUROC of LAD in predicting postoperative recurrence of atrial fibrillation was 0.666(95%CI 0.605-0.723).The ROC curves of LAD and C2HEST or HATCH scores were compared by De Long test,and the P-values obtained were all less than 0.001,indicating that the ability of LAD to predict the late recurrence after RFCA of atrial fibrillation patients was inferior to that of the C2HEST and HATCH scores.Conclusion: 1.Both C2HEST and HATCH scores are reliable predictors of late recurrence after RFCA;2.Among the risk factors included in the two scores,hypertension and heart failure(HF)contributed the most to postoperative recurrence after AF;3.LAD is an independent predictor of late recurrence after RFCA,but it is significantly less powerful than C2HEST and HATCH scores. |
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