Abstract：
BACKGROUND: New-onset atrial fibrillation (NeAF) is common after cavotricuspid isthmus-dependent counterclockwise atrial flutter (CCW-AFL) ablation. This study aimed to investigate a simple predictive model of NeAF after CCW-AFL ablation.
METHODS: From January 2013, to December 2017, consecutive patients receiving CCW-AFL ablation were enrolled from 3 centres. Clinical, echocardiographic, and electrocardiographic data were collected and followed. Patients from 2 centres and another centre were assigned into the derivation and validation cohorts, respectively. In the derivation cohort, logistic regression was performed to evaluate the ability of parameters to discriminate those with and without NeAF. A score system was developed and then validated.
RESULTS: Two hundred seventy-one patients (mean 59.7 ± 13.6 age; 205 male) were analyzed. During follow-up (73.0 ± 6.5 months), 107 patients (39.5%) had NeAF; 190 and 81 patients were detected in the derivation and validation cohorts, respectively. Hypertension, age ≥ 70 years, left atrial diameter ≥ 42 mm, P-wave duration ≥ 120 ms and the negative component of flutter wave in lead II ≥ 120 ms were selected as the final parameters. A weighted score was used to develop the HAD-AF score ranging from 0 to 9. In the derivation cohort, area under the receiver operating characteristic curve (AUC) was 0.938 (95% confidence interval [CI], 0.902-0.974), superior to those of currently used CHA2DS2-VASC (0.679, 95% CI, 0.600-0.757) and HATCH scores (0.651, 95% CI, 0.571-0.730) (P < 0.001). Performance maintained in the validation cohort.
CONCLUSIONS: Six years after CCW-AFL ablation, 39.5% of patients developed NeAF. HAD-AF score can reliably identify patients likely to develop NeAF after CCW-AFL ablation.
METHODS: From January 2013, to December 2017, consecutive patients receiving CCW-AFL ablation were enrolled from 3 centres. Clinical, echocardiographic, and electrocardiographic data were collected and followed. Patients from 2 centres and another centre were assigned into the derivation and validation cohorts, respectively. In the derivation cohort, logistic regression was performed to evaluate the ability of parameters to discriminate those with and without NeAF. A score system was developed and then validated.
RESULTS: Two hundred seventy-one patients (mean 59.7 ± 13.6 age; 205 male) were analyzed. During follow-up (73.0 ± 6.5 months), 107 patients (39.5%) had NeAF; 190 and 81 patients were detected in the derivation and validation cohorts, respectively. Hypertension, age ≥ 70 years, left atrial diameter ≥ 42 mm, P-wave duration ≥ 120 ms and the negative component of flutter wave in lead II ≥ 120 ms were selected as the final parameters. A weighted score was used to develop the HAD-AF score ranging from 0 to 9. In the derivation cohort, area under the receiver operating characteristic curve (AUC) was 0.938 (95% confidence interval [CI], 0.902-0.974), superior to those of currently used CHA2DS2-VASC (0.679, 95% CI, 0.600-0.757) and HATCH scores (0.651, 95% CI, 0.571-0.730) (P < 0.001). Performance maintained in the validation cohort.
CONCLUSIONS: Six years after CCW-AFL ablation, 39.5% of patients developed NeAF. HAD-AF score can reliably identify patients likely to develop NeAF after CCW-AFL ablation.
摘要：
背景：新发房颤（NeAF）在三尖瓣峡部依赖性逆时针房扑（CCW-AFL）消融术后很常见。本研究旨在探讨CCW-AFL消融后NeAF的简单预测模型。
方法：从2013年1月至2017年12月，从三个中心连续纳入接受CCW-AFL消融的患者。临床,超声心动图,收集和随访心电图数据.来自两个中心和另一个中心的患者被分配到推导和验证队列中，分别。在派生队列中，进行逻辑回归以评估参数区分是否有NeAF的能力。开发了评分系统，然后进行了验证。
结果：分析了二百七十一名患者（平均59.7±13.6岁；205名男性）。随访期间（73.0±6.5个月），107例患者（39.5%）有NeAF。在推导和验证队列中检测到190例和81例患者，分别。高血压,年龄≥70岁，左心房直径≥42mm,选择P波持续时间≥120ms和II导联颤振的负分量≥120ms作为最终参数。使用加权评分来开发范围从0到9的HAD-AF评分。在派生队列中，受试者工作特征曲线下面积（AUC）为0.938（95％CI0.902-0.974），优于目前使用的CHA2DS2-VASC（0.679，95%CI0.600-0.757）和HATCH评分（0.651，95%CI0.571-0.730）（P<0.001）。在验证队列中保持性能。
结论：39.5%的患者在CCW-AFL消融术后6年内出现NeAF。HAD-AF评分可以可靠地识别CCW-AFL消融术后可能发生NeAF的患者。
方法：从2013年1月至2017年12月，从三个中心连续纳入接受CCW-AFL消融的患者。临床,超声心动图,收集和随访心电图数据.来自两个中心和另一个中心的患者被分配到推导和验证队列中，分别。在派生队列中，进行逻辑回归以评估参数区分是否有NeAF的能力。开发了评分系统，然后进行了验证。
结果：分析了二百七十一名患者（平均59.7±13.6岁；205名男性）。随访期间（73.0±6.5个月），107例患者（39.5%）有NeAF。在推导和验证队列中检测到190例和81例患者，分别。高血压,年龄≥70岁，左心房直径≥42mm,选择P波持续时间≥120ms和II导联颤振的负分量≥120ms作为最终参数。使用加权评分来开发范围从0到9的HAD-AF评分。在派生队列中，受试者工作特征曲线下面积（AUC）为0.938（95％CI0.902-0.974），优于目前使用的CHA2DS2-VASC（0.679，95%CI0.600-0.757）和HATCH评分（0.651，95%CI0.571-0.730）（P<0.001）。在验证队列中保持性能。
结论：39.5%的患者在CCW-AFL消融术后6年内出现NeAF。HAD-AF评分可以可靠地识别CCW-AFL消融术后可能发生NeAF的患者。
