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已发表论文
非阵发性心房颤动肺静脉隔离术后心房颤动复发的 11 种预后评分比较评估：一项回顾性比较分析
Authors Guan LX, Chen XH, Xu Z, Gong KZ, Zhang FL
Received 28 August 2025
Accepted for publication 15 December 2025
Published 26 December 2025 Volume 2025:21 Pages 1833—1845
DOI https://doi.org/10.2147/TCRM.S563768
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Garry Walsh
Lin-Xin Guan, Xue-Hai Chen, Zhe Xu, Ke-Zeng Gong, Fei-Long Zhang
Department of Cardiology, Fujian Medical University Union Hospital; Fujian Cardiovascular Medicine Center; Fujian Institute of Coronary Artery Disease; Fujian Cardiovascular Research Center; Fujian Medical University Heart Center, Fuzhou, 350001, People’s Republic of China
Correspondence: Fei-Long Zhang, Department of Cardiology, Fujian Medical University Union Hospital; Fujian Cardiovascular Medicine Center; Fujian Institute of Coronary Artery Disease; Fujian Cardiovascular Research Center; Fujian Medical University Heart Center, No. 29 of Xinquan Road, Gulou District, Fuzhou, 350001, People’s Republic of China, Tel +86 13365910662, Fax +86 091 83322156, Email cardizhang@163.com
Objective: Pulmonary vein isolation (PVI) remains the cornerstone of catheter ablation for atrial fibrillation (AF); however, a substantial proportion of patients with non-paroxysmal AF (non-PAF) experience recurrence following ablation. With numerous prognostic models available to predict recurrence, the aim of this study is to compare the predictive performance of multiple scoring systems in patients with non-PAF undergoing PVI as a standalone procedure.
Methods: A retrospective analysis was conducted involving 166 patients with non-PAF (22.3% female; mean age 60 ± 9 years) who underwent initial PVI alone. Clinical data, including transthoracic echocardiography and either cardiac computed tomography or transesophageal echocardiography, were collected. The evaluated prognostic scoring systems included APPLE, BASE-AF2, C2HEST, CAAP-AF, CHA2DS2-VASc, CHADS2, DR-FLASH, HATCH, MB-LATER, PAT2C2H, and SCALE-CryoAF.
Results: Recurrence of AF following a 90-day blanking period was observed in 41 individuals (24.7%), including 24 (51.8%) in the cryo-balloon ablation (CBA) subgroup and 17 (48.2%) in the radiofrequency catheter ablation (RFCA) subgroup. Among the evaluated models, BASE-AF2 (AUC = 0.666, 95% CI: 0.572– 0.759, p = 0.001), MB-LATER (AUC = 0.734, 95% CI: 0.646– 0.821, p < 0.001), and SCALE-CryoAF (AUC = 0.702, 95% CI: 0.600– 0.804, p < 0.001) demonstrated superior prognostic performance for recurrence. After propensity score matching, MB-LATER (AUC = 0.734, 95% CI: 0.570– 0.899, p = 0.019) was identified as the most effective predictor of recurrence in the CBA subgroup, while BASE-AF2 (AUC = 0.758, 95% CI: 0.578– 0.937, p = 0.013) indicated superior predictive accuracy in the RFCA subgroup.
Conclusion: The BASE-AF2, MB-LATER, and SCALE-CryoAF scoring systems demonstrated enhanced prognostic use for predicting AF recurrence following PVI alone in patients with non-PAF. MB-LATER exhibited superior performance in those treated with CBA, while BASE-AF2 was more predictive for those who underwent RFCA.
Keywords: catheter ablation, non-paroxysmal atrial fibrillation, pulmonary vein isolation, risk score
Department of Cardiology, Fujian Medical University Union Hospital; Fujian Cardiovascular Medicine Center; Fujian Institute of Coronary Artery Disease; Fujian Cardiovascular Research Center; Fujian Medical University Heart Center, Fuzhou, 350001, People’s Republic of China
Correspondence: Fei-Long Zhang, Department of Cardiology, Fujian Medical University Union Hospital; Fujian Cardiovascular Medicine Center; Fujian Institute of Coronary Artery Disease; Fujian Cardiovascular Research Center; Fujian Medical University Heart Center, No. 29 of Xinquan Road, Gulou District, Fuzhou, 350001, People’s Republic of China, Tel +86 13365910662, Fax +86 091 83322156, Email cardizhang@163.com
Objective: Pulmonary vein isolation (PVI) remains the cornerstone of catheter ablation for atrial fibrillation (AF); however, a substantial proportion of patients with non-paroxysmal AF (non-PAF) experience recurrence following ablation. With numerous prognostic models available to predict recurrence, the aim of this study is to compare the predictive performance of multiple scoring systems in patients with non-PAF undergoing PVI as a standalone procedure.
Methods: A retrospective analysis was conducted involving 166 patients with non-PAF (22.3% female; mean age 60 ± 9 years) who underwent initial PVI alone. Clinical data, including transthoracic echocardiography and either cardiac computed tomography or transesophageal echocardiography, were collected. The evaluated prognostic scoring systems included APPLE, BASE-AF2, C2HEST, CAAP-AF, CHA2DS2-VASc, CHADS2, DR-FLASH, HATCH, MB-LATER, PAT2C2H, and SCALE-CryoAF.
Results: Recurrence of AF following a 90-day blanking period was observed in 41 individuals (24.7%), including 24 (51.8%) in the cryo-balloon ablation (CBA) subgroup and 17 (48.2%) in the radiofrequency catheter ablation (RFCA) subgroup. Among the evaluated models, BASE-AF2 (AUC = 0.666, 95% CI: 0.572– 0.759, p = 0.001), MB-LATER (AUC = 0.734, 95% CI: 0.646– 0.821, p < 0.001), and SCALE-CryoAF (AUC = 0.702, 95% CI: 0.600– 0.804, p < 0.001) demonstrated superior prognostic performance for recurrence. After propensity score matching, MB-LATER (AUC = 0.734, 95% CI: 0.570– 0.899, p = 0.019) was identified as the most effective predictor of recurrence in the CBA subgroup, while BASE-AF2 (AUC = 0.758, 95% CI: 0.578– 0.937, p = 0.013) indicated superior predictive accuracy in the RFCA subgroup.
Conclusion: The BASE-AF2, MB-LATER, and SCALE-CryoAF scoring systems demonstrated enhanced prognostic use for predicting AF recurrence following PVI alone in patients with non-PAF. MB-LATER exhibited superior performance in those treated with CBA, while BASE-AF2 was more predictive for those who underwent RFCA.
Keywords: catheter ablation, non-paroxysmal atrial fibrillation, pulmonary vein isolation, risk score