Establishment and evaluation of a nomogram prediction model for risk of atrial fibrillation recurrence after the cox-maze IV procedure
Abstract The Cox-Maze IV (CMIV) procedure is the mainstay in surgical treatment of atrial fibrillation (AF), but the rate of AF recurrence after the CMIV procedure in patients with persistent AF is difficult to accurately evaluate. In this study, we aimed to develop and validate a risk prediction mo...
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BMC
2025-01-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-025-03356-3 |
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| author | Chuang Yu Yanan Wei Huajie Zheng Sanjiu Yu Yongbo Cheng Chaojun Yan Jun Li Ping He Wei Cheng |
| author_facet | Chuang Yu Yanan Wei Huajie Zheng Sanjiu Yu Yongbo Cheng Chaojun Yan Jun Li Ping He Wei Cheng |
| author_sort | Chuang Yu |
| collection | DOAJ |
| description | Abstract The Cox-Maze IV (CMIV) procedure is the mainstay in surgical treatment of atrial fibrillation (AF), but the rate of AF recurrence after the CMIV procedure in patients with persistent AF is difficult to accurately evaluate. In this study, we aimed to develop and validate a risk prediction model of AF recurrence within 1 year after undergoing the Cox-Maze IV procedure. We retrospectively enrolled 303 consecutive patients who underwent the Cox-Maze IV procedure for persistent AF concomitant with other cardiac procedures at our institute between 2019 and 2021. A nomogram was developed using multivariate logistic regression analysis, and the concordance statistic (C-statistic) was computed. Differentiation, calibration, clinical suitability, and bootstrapping were performed to verify the model. Among the 303 patients, 71 developed recurrent AF within 1 year of CMIV. Factors predictive of postoperative AF recurrence included age, left ventricular hypertrophy (LVH), early atrial tachyarrhythmias (ATAs), and congenital heart disease surgery (namely, ventricular septal defect repair and atrial septal defect repair). Based on the training dataset, the nomogram had a C-statistic of 0.864 (95% CI 0.811–0.918) for predicting AF recurrence. According to the receiver operating characteristic curve, (ROC curve), the cutoff value of the model was 0.293, and the specificity and sensitivity were 0.841 and 0.789, respectively. This model can predict the risk of AF recurrence after the CMIV procedure. Its discrimination, calibration, and clinical applicability are strong, and its clinical application is simple and easy to promote. |
| format | Article |
| id | doaj-art-45713905c9594e429c737ce91d263d49 |
| institution | Kabale University |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-45713905c9594e429c737ce91d263d492025-01-26T12:51:59ZengBMCJournal of Cardiothoracic Surgery1749-80902025-01-012011910.1186/s13019-025-03356-3Establishment and evaluation of a nomogram prediction model for risk of atrial fibrillation recurrence after the cox-maze IV procedureChuang Yu0Yanan Wei1Huajie Zheng2Sanjiu Yu3Yongbo Cheng4Chaojun Yan5Jun Li6Ping He7Wei Cheng8Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Prevention and Healthcare, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Abstract The Cox-Maze IV (CMIV) procedure is the mainstay in surgical treatment of atrial fibrillation (AF), but the rate of AF recurrence after the CMIV procedure in patients with persistent AF is difficult to accurately evaluate. In this study, we aimed to develop and validate a risk prediction model of AF recurrence within 1 year after undergoing the Cox-Maze IV procedure. We retrospectively enrolled 303 consecutive patients who underwent the Cox-Maze IV procedure for persistent AF concomitant with other cardiac procedures at our institute between 2019 and 2021. A nomogram was developed using multivariate logistic regression analysis, and the concordance statistic (C-statistic) was computed. Differentiation, calibration, clinical suitability, and bootstrapping were performed to verify the model. Among the 303 patients, 71 developed recurrent AF within 1 year of CMIV. Factors predictive of postoperative AF recurrence included age, left ventricular hypertrophy (LVH), early atrial tachyarrhythmias (ATAs), and congenital heart disease surgery (namely, ventricular septal defect repair and atrial septal defect repair). Based on the training dataset, the nomogram had a C-statistic of 0.864 (95% CI 0.811–0.918) for predicting AF recurrence. According to the receiver operating characteristic curve, (ROC curve), the cutoff value of the model was 0.293, and the specificity and sensitivity were 0.841 and 0.789, respectively. This model can predict the risk of AF recurrence after the CMIV procedure. Its discrimination, calibration, and clinical applicability are strong, and its clinical application is simple and easy to promote.https://doi.org/10.1186/s13019-025-03356-3Atrial fibrillationCox-Maze IV procedureRisk score modelPredictionPrognosis |
| spellingShingle | Chuang Yu Yanan Wei Huajie Zheng Sanjiu Yu Yongbo Cheng Chaojun Yan Jun Li Ping He Wei Cheng Establishment and evaluation of a nomogram prediction model for risk of atrial fibrillation recurrence after the cox-maze IV procedure Journal of Cardiothoracic Surgery Atrial fibrillation Cox-Maze IV procedure Risk score model Prediction Prognosis |
| title | Establishment and evaluation of a nomogram prediction model for risk of atrial fibrillation recurrence after the cox-maze IV procedure |
| title_full | Establishment and evaluation of a nomogram prediction model for risk of atrial fibrillation recurrence after the cox-maze IV procedure |
| title_fullStr | Establishment and evaluation of a nomogram prediction model for risk of atrial fibrillation recurrence after the cox-maze IV procedure |
| title_full_unstemmed | Establishment and evaluation of a nomogram prediction model for risk of atrial fibrillation recurrence after the cox-maze IV procedure |
| title_short | Establishment and evaluation of a nomogram prediction model for risk of atrial fibrillation recurrence after the cox-maze IV procedure |
| title_sort | establishment and evaluation of a nomogram prediction model for risk of atrial fibrillation recurrence after the cox maze iv procedure |
| topic | Atrial fibrillation Cox-Maze IV procedure Risk score model Prediction Prognosis |
| url | https://doi.org/10.1186/s13019-025-03356-3 |
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