Explore The Value Of ABC Score In Predicting Late Recurrence Of Paroxysmal Atrial Fibrillation After Radiofrequency Ablation

Background: atrial fibrillation(AF)is one of the most common arrhythmias in clinic.Although radiofrequency Catheter ablation(RFCA)is making continuous progress,there is still a certain recurrence rate after RFCA.Biomarkers such as NT-pro BNP are associated with recurrence of RFCA,but the existing risk score of recurrence of RFCA is not included in biomarkers.To explore the relationship between ABC score that includes biomarkers and recurrence of RFCA,to guide clinicians to better screen surgical cases and improve the long-term success rate of operation.Objective: to investigate the relationship between ABC score and recurrence after RFCA of atrial fibrillation and its predictive value.Methods: 132 patients who underwent RFCA in the Department of Cardiology of affiliated Union Hospital of Fujian Medical University from October 2018 to September 2019 were studied retrospectively.1、according to the late recurrence after catheter ablation,the patients were divided into two groups: late recurrence group(n = 27)and late non-recurrence group(n= 105).The factors affecting the late recurrence of atrial fibrillation were discussed.2、According to the best cut-off point of ABC score obtained from the previous study,patients with AF were divided into two groups: the group with higher ABC score(≥ 6.5)and the group with lower ABC score(< 6.5).The difference of late recurrence rate after RFCA was compared between the two groups.Results: 1.The average follow-up time was 8.00(6.00-10.75)months,and27 cases(21%)have late recurrence.Univariate analysis showed that the potential risk factors for late recurrence of RFCA had early recurrence,ABC score and NT-pro BNP,CHA2DS2–VASc.According to Cox multivariate analysis,ABC score(P=0.006,HR=1.121,95% CI:1.034-1.215)and early recurrence(P= 0.000 HR=16.200% 95%CI : 6.673-39.329)were independent predictors of late recurrence of AF.The area under the ROC curve for predicting late recurrence of RFCA of ABC score was 0.687(95%CI0.570-0.786),and the best cut-off point was 6.5(sensitivity 66.7%,specificity 65.7%).2.according to the results of the previous study,the patient was divided into two groups according to the best cut-off point of ABC score: higher ABC score group(≥ 6.5)and lower ABC score group(<6.5).There were significant differences in the left atrial diameter and early recurrence of atrial fibrillation between the higher ABC score group and the lower ABC score group(P < 0.1).After matching the propensity score between the two groups,there were 51 patients in each group.Kaplan-Meier analysis(Breslow test)showed that the late recurrence rate of AF in the group with higher ABC score was higher than that in the lower group(P=0.013).Univariate binomial Logistic regression analysis indicate ABC score was a risk factor(P=0.042,HR=2.687,95%CI:1.036-6.971)for late recurrence of PAF.The area under the ROC curve for predicting late recurrence of PAF after ablation of ABC score was 0.742(95%CI0.643-0.842),and the best cut-off point was 6.4(sensitivity 92.0%,specificity 40.3%).Conclusion: ABC score ≥ 6.4 is a predictor of late recurrence rate increasing after radiofrequency ablation of paroxysmal atrial fibrillation.