CHA2DS2‐VASc Score as a Predictor for Atrial Fibrillation Recurrence and Clinical Outcomes Following Pulmonary Vein Isolation

ABSTRACT Background Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with serious cardiovascular complications such as ischemic stroke, heart failure, and myocardial infarction. Pulmonary vein isolation (PVI) is an established rhythm‐control strategy for...

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Main Authors: Mustafa Gabarin, Mahmoud Suleiman, Adi Elias, Ibrahim Marai, Roy Beinart, Eyal Nof, Yoav Michowitz, Michael Glikson, Yuval Konstantino, Moti Haim, David Luria, David Pereg, Avishag Laish‐Farkash, Alexander Omelchenko, the Israeli Working Group on Pacing Electrophysiology
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Annals of Noninvasive Electrocardiology
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Online Access:https://doi.org/10.1111/anec.70088
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author Mustafa Gabarin
Mahmoud Suleiman
Adi Elias
Ibrahim Marai
Roy Beinart
Eyal Nof
Yoav Michowitz
Michael Glikson
Yuval Konstantino
Moti Haim
David Luria
David Pereg
Avishag Laish‐Farkash
Alexander Omelchenko
the Israeli Working Group on Pacing Electrophysiology
author_facet Mustafa Gabarin
Mahmoud Suleiman
Adi Elias
Ibrahim Marai
Roy Beinart
Eyal Nof
Yoav Michowitz
Michael Glikson
Yuval Konstantino
Moti Haim
David Luria
David Pereg
Avishag Laish‐Farkash
Alexander Omelchenko
the Israeli Working Group on Pacing Electrophysiology
author_sort Mustafa Gabarin
collection DOAJ
description ABSTRACT Background Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with serious cardiovascular complications such as ischemic stroke, heart failure, and myocardial infarction. Pulmonary vein isolation (PVI) is an established rhythm‐control strategy for AF. Although the CHA2DS2‐VASc score is primarily used to estimate stroke risk in patients with AF, its potential utility in predicting AF recurrence after PVI has not been fully explored in contemporary, real‐world multicenter settings. Aim To evaluate the association between the CHA2DS2‐VASc score and both AF recurrence and adverse clinical outcomes following PVI. Methods We conducted a retrospective cohort study using the Israeli Catheter Ablation Registry (ICAR), including 860 patients undergoing their first PVI for AF. Patients were grouped by CHA2DS2‐VASc score (0–1, 2–4, > 5). The primary endpoint was AF recurrence within 12 months. Secondary endpoints included re‐hospitalization, major adverse cardiovascular events (MACE), and all‐cause mortality. Results AF recurrence occurred in 32% of patients. Recurrence rates were 25.7%, 31.4%, and 51% across the low, intermediate, and high CHA2DS2‐VASc score groups, respectively. A higher score was independently associated with increased recurrence risk (HR = 2.88; 95% CI, 1.75–4.74; p < 0.001). Elevated CHA2DS2‐VASc scores also correlated with higher MACE and re‐hospitalization rates. No significant difference in all‐cause mortality was observed. Conclusion The CHA2DS2‐VASc score is an independent predictor of AF recurrence and adverse outcomes after PVI. Its simplicity, availability, and routine use make it a clinically useful tool to support preprocedural risk stratification in AF patients undergoing ablation.
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spelling doaj-art-e699b9e511b2456cbd6cbb16e2cdef8c2025-08-20T03:48:23ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2025-05-01303n/an/a10.1111/anec.70088CHA2DS2‐VASc Score as a Predictor for Atrial Fibrillation Recurrence and Clinical Outcomes Following Pulmonary Vein IsolationMustafa Gabarin0Mahmoud Suleiman1Adi Elias2Ibrahim Marai3Roy Beinart4Eyal Nof5Yoav Michowitz6Michael Glikson7Yuval Konstantino8Moti Haim9David Luria10David Pereg11Avishag Laish‐Farkash12Alexander Omelchenko13the Israeli Working Group on Pacing ElectrophysiologyCardiology Department, Meir Medical Center, Kfar‐Saba and Sackler Faculty of Medicine Tel‐Aviv University Tel Aviv IsraelEyal Ofer Heart Hospital, Cardiac Electrophysiology and Pacing Rambam Health Care Campus Haifa IsraelEyal Ofer Heart Hospital, Cardiac Electrophysiology and Pacing Rambam Health Care Campus Haifa IsraelCardiology Department, Baruch Padeh Medical Center, the Azrieli Faculty of Medicine in the Galilee Bar‐Ilan University Safed IsraelHeart Institute, Sheba Medical Center, Tel‐Hashomer, Israel and Sackler School of Medicine Tel Aviv IsraelHeart Institute, Sheba Medical Center, Tel‐Hashomer, Israel and Sackler School of Medicine Tel Aviv IsraelJesselson Integrated Heart Center Shaare Zedek Medical Center and Hebrew University Jerusalem IsraelJesselson Integrated Heart Center Shaare Zedek Medical Center and Hebrew University Jerusalem IsraelDepartment of Cardiology, Cardiac Electrophysiology and Pacing Soroka University Hospital, ben‐Gurion University of the Negev Beer‐Sheva IsraelDepartment of Cardiology, Cardiac Electrophysiology and Pacing Soroka University Hospital, ben‐Gurion University of the Negev Beer‐Sheva IsraelDepartment of Cardiology, Hadassah Medical Organization and Faculty of Medicine Hebrew University of Jerusalem Jerusalem IsraelCardiology Department, Meir Medical Center, Kfar‐Saba and Sackler Faculty of Medicine Tel‐Aviv University Tel Aviv IsraelDepartment of Cardiology, Electrophysiology and Pacing Unit Assuta Ashdod University Medical Center, ben‐Gurion University of the Negev Ashdod IsraelCardiology Department, Meir Medical Center, Kfar‐Saba and Sackler Faculty of Medicine Tel‐Aviv University Tel Aviv IsraelABSTRACT Background Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with serious cardiovascular complications such as ischemic stroke, heart failure, and myocardial infarction. Pulmonary vein isolation (PVI) is an established rhythm‐control strategy for AF. Although the CHA2DS2‐VASc score is primarily used to estimate stroke risk in patients with AF, its potential utility in predicting AF recurrence after PVI has not been fully explored in contemporary, real‐world multicenter settings. Aim To evaluate the association between the CHA2DS2‐VASc score and both AF recurrence and adverse clinical outcomes following PVI. Methods We conducted a retrospective cohort study using the Israeli Catheter Ablation Registry (ICAR), including 860 patients undergoing their first PVI for AF. Patients were grouped by CHA2DS2‐VASc score (0–1, 2–4, > 5). The primary endpoint was AF recurrence within 12 months. Secondary endpoints included re‐hospitalization, major adverse cardiovascular events (MACE), and all‐cause mortality. Results AF recurrence occurred in 32% of patients. Recurrence rates were 25.7%, 31.4%, and 51% across the low, intermediate, and high CHA2DS2‐VASc score groups, respectively. A higher score was independently associated with increased recurrence risk (HR = 2.88; 95% CI, 1.75–4.74; p < 0.001). Elevated CHA2DS2‐VASc scores also correlated with higher MACE and re‐hospitalization rates. No significant difference in all‐cause mortality was observed. Conclusion The CHA2DS2‐VASc score is an independent predictor of AF recurrence and adverse outcomes after PVI. Its simplicity, availability, and routine use make it a clinically useful tool to support preprocedural risk stratification in AF patients undergoing ablation.https://doi.org/10.1111/anec.70088AF recurrenceatrial fibrillation (AF)CHA2DS2‐VASc scorepulmonary vein isolation (PVI)
spellingShingle Mustafa Gabarin
Mahmoud Suleiman
Adi Elias
Ibrahim Marai
Roy Beinart
Eyal Nof
Yoav Michowitz
Michael Glikson
Yuval Konstantino
Moti Haim
David Luria
David Pereg
Avishag Laish‐Farkash
Alexander Omelchenko
the Israeli Working Group on Pacing Electrophysiology
CHA2DS2‐VASc Score as a Predictor for Atrial Fibrillation Recurrence and Clinical Outcomes Following Pulmonary Vein Isolation
Annals of Noninvasive Electrocardiology
AF recurrence
atrial fibrillation (AF)
CHA2DS2‐VASc score
pulmonary vein isolation (PVI)
title CHA2DS2‐VASc Score as a Predictor for Atrial Fibrillation Recurrence and Clinical Outcomes Following Pulmonary Vein Isolation
title_full CHA2DS2‐VASc Score as a Predictor for Atrial Fibrillation Recurrence and Clinical Outcomes Following Pulmonary Vein Isolation
title_fullStr CHA2DS2‐VASc Score as a Predictor for Atrial Fibrillation Recurrence and Clinical Outcomes Following Pulmonary Vein Isolation
title_full_unstemmed CHA2DS2‐VASc Score as a Predictor for Atrial Fibrillation Recurrence and Clinical Outcomes Following Pulmonary Vein Isolation
title_short CHA2DS2‐VASc Score as a Predictor for Atrial Fibrillation Recurrence and Clinical Outcomes Following Pulmonary Vein Isolation
title_sort cha2ds2 vasc score as a predictor for atrial fibrillation recurrence and clinical outcomes following pulmonary vein isolation
topic AF recurrence
atrial fibrillation (AF)
CHA2DS2‐VASc score
pulmonary vein isolation (PVI)
url https://doi.org/10.1111/anec.70088
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