Development and Validation of a Nomogram for Predicting Recurrence in
Patients with AF Who Underwent Ablation within one year
Abstract
Background:With the improvement of radiofrequency catheter ablation
technology, an increasing number of patients with atrial fibrillation
(AF) choose it as the treatment option. However, the individual
recurrence rate after ablation is difficult to accurately predict.
Objective:This study aimed to develop and validate an effective
prognostic nomogram for predicting long-term recurrence of patients with
AF who underwent ablation. Methods: We conducted a retrospective
single-center cohort study of 493 patients with AF from five wards in
The First Affiliated Hospital of Soochow University from January 1, 2015
to December 31, 2019. Three quarters of patients(n=371) were randomly
assigned to the training cohort, and the rest (n=122) were assigned to
the validation cohort. Univariate and multivariate cox regression
analysis was performed using R software version 3.6.2 to prognostic
variables for recurrence and develop a nomogram. The C index, ROC,
calibration curve, Greenwood-D’Agostino-Nam, and DCA were used for
verification in the modeling cohort and the verification cohort
respectively for validation. Results: Multivariate cox regression
analysis shown that 6 independent predictors were identified: age,
female, AF duration, AF type, coronary artery disease, left atrial
diameter. And these predictors were entered into the nomogram, which
shown favorable discrimination and calibration both in the training
cohort and validation cohort. Conclusion: The proposed nomogram can
accurately predict recurrence of patients after AF ablation. Compared to
the CHA2DS2-VASc score, clinicians can promote individual-oriented
therapy and disease management by using this tool.