Can CHA2DS2-VASc Predict Recurrence of Atrial Fibrillation?

February 4, 2019

Atrial fibrillation recurrence remains a challenge amidst significant advances in managing stroke risk. Could the CHA2DS2-VASc score help?

Can CHA₂DS₂-VASc Predict AF Recurrence?

Could a CHA₂DS₂-VASc Score Predict AF Recurrence? Research suggests the score may be a marker for atrial remodeling and physiologic changes that may both serve to trigger/perpetuate the arrhythmia.

Review and Pooled Meta-analysis. Data pooled for 2889 patients from 7 studies: 61% male, 50% with hypertension, 12% with diabetes, 23% with ischemic heart disease; median CHA₂DS₂-VASc score=2 (low stroke risk).

CHA₂DS₂-VASc Among Predictors of Early AF Recurrence. Other independent predictors of AF recurrence within 30 days post-cardioversion: Chronic kidney disease, peripheral artery disease, past Ã-blocker use.

Cutoff for AF Recurrence: CHA₂DS₂-VASc ≥2. There was an observed 37% increased risk of AF recurrence with CHA₂DS₂-VASc score ≥ 2. Sensitivity, 64.8%; specificity 48.4%.

Take Home Points

Pooled meta-analysis suggests CHA₂DS₂-VASC score ≥ 2 may predict early AF recurrence after cardioversion in patients with low stroke risk, especially in CKD and PAD

First report of predictive value of CHA₂DS₂-VASc for AF recurrence in CKD

Less than ideal sensitivity, specificity and accuracy of CHA₂DS₂-VASc ≥ 2 for predicting AF recurrence