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Personalized assessment of the cumulative complication risk of the atrial fibrillation ablation track_HeartRythm.pdf (943.77 KB)

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2022-08-09

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cc by (c) Bisbal, Felipe et al, 2022
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/200203

Personalized assessment of the cumulative complication risk of the atrial fibrillation ablation track: The AF-TRACK calculator

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Recurs relacionat

https://doi.org/10.1016/j.hroo.2022.07.013

Resum

Atrial fibrillation (AF) ablation strategy is associated with a non-negligible risk of complications and often requires repeat procedures (AF ablation track), implying repetitive exposure to procedural risk.The purpose of this study was to develop and validate a model to estimate individualized cumulative risk of complications in patients undergoing the AF ablation track (Atrial Fibrillation TRAck Complication risK [AF-TRACK] calculator).The model was derived from a multicenter cohort including 3762 AF ablation procedures in 2943 patients. A first regression model was fitted to predict the propensity for repeat ablation. The AF-TRACK calculator computed the risk of AF ablation track complications, considering the propensity for repeat ablation. Internal (cross-validation) and external (independent cohort) validation were assessed for discrimination capacity (area under the curve [AUC]) and goodness of fit (Hosmer-Lemeshow [HL] test).Complications (N = 111) occurred in 3.7% of patients (2.9% of procedures). Predictors included female sex, heart failure, sleep apnea syndrome, and repeat procedures. The model showed fair discrimination capacity to predict complications (AUC 0.61 [0.55-0.67]) and likelihood of repeat procedure (AUC 0.62 [0.60-0.64]), with good calibration (HL χ2 12.5; P = .13). The model maintained adequate discrimination capacity (AUC 0.67 [0.57-0.77]) and calibration (HL χ2 5.6; P = .23) in the external validation cohort. The validated model was used to create the Web-based AF-TRACK calculator.The proposed risk model provides individualized estimates of the cumulative risk of complications of undergoing the AF ablation track. The AF-TRACK calculator is a validated, easy-to-use, Web-based clinical tool to calibrate the risk-to-benefit ratio of this treatment strategy.© 2022 Heart Rhythm Society. Published by Elsevier Inc.

Matèries

Arrítmia, Avaluació del risc

Matèries (anglès)

Arrhythmia, Risk assessment

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Col·leccions

Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

BISBAL, Felipe, ABUGATTAS, Juan pablo, TROTTA, Omar, GONZÁLEZ FERRER, Juan josé, SAURÍ ORTIZ, Assumpció, ARIAS, Miguel ángel, SUBIRANA CACHINERO, Isaac, DUYTSHAEVER, Mattias, POOTER, Jan de, SARRIAS, Axel, ADELIÑO, Raquel, ALARCÓN, Francisco, MONT GIRBAU, Lluís, PÉREZ VILLACASTÍN, Julián, OSCA ASENSI, Joaquin, VILLUENDAS, Roger, PACHÓN IGLESIAS, Marta, EL HADDAD, Milad, BAYÉS GENÍS, Antoni, GREEF, Yves de. Personalized assessment of the cumulative complication risk of the atrial fibrillation ablation track: The AF-TRACK calculator. _Heart Rhythm O2_. 2022. Vol. 3, núm. 6, pàgs. 656-664. [consulta: 8 de gener de 2026]. ISSN: 2666-5018. [Disponible a: https://hdl.handle.net/2445/200203]

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