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
