This review article provides an overview on the published clinical risk scores related to outcomes of rhythm control strategy or AF progression
Patients with atrial fibrillation ( AF ) are commonly managed with rhythm control strategy , but the natural history of this common arrhythmia leads itself to progression from paroxysmal to persistent or permanent AF , and recurrences are evident despite rhythm control treatments using cardioversion or catheter ablation .
Numerous clinical factors have been associated with outcomes of rhythm control or arrhythmia progression in patients with AF .
The more common factors have been used to formulate risk stratification scores , to help predict the outcomes of rhythm control treatments  or AF progression .
No Benefit of Complex Fractionated Atrial Electrogram Ablation in Addition to Circumferential Pulmonary Vein Ablation and Linear Ablation: Benefit of Complex Ablation Study
Background —The optimal ablation strategy for persistent atrial fibrillation ( AF ) remains unclear . Methods and Results —This multicentre r and omized study compared circumferential pulmonary vein ablation+linear ablation ( control arm ) versus circumferential pulmonary vein ablation+linear ablation+complex fractionated atrial electrogram ( CFAE ) ablation ( CFAE arm ) in patients with persistent AF .  Circumferential pulmonary vein ablation was performed followed by roof and mitral isthmus ablation , before CFAE ablation in the CFAE arm . Ablation strategy was maintained at the first redo procedure . Sixty-five patients were recruited in each arm . The mean age was 61±10 years , 75 % were men , median AF duration was 2 years , 42 % had long-lasting persistent AF , 68 % had associated cardiovascular disease , mean left atrial dimension was 46±6 mm , and median CHA2DS2-VASc score was 2 .  Ablation and procedure times were significantly longer in the CFAE arm ( 70±20 versus 55±17 ; 201±35 versus 152±45 minutes ; P<0.005 ) . After a mean follow-up of 35±5 months , single-procedural success off antiarrhythmic drugs at 12 months ( CFAE : 30/65 [ 46 % ] versus control : 37/65 [ 57 % ] ; P=0.29 ) and multiprocedural success ( CFAE : 51/65 [ 78 % ] versus control : 52/65 [ 80 % ] ; P=1.0 ) were not significantly different . At the first redo procedure , patients in the CFAE arm had a higher incidence of organized atrial tachycardia/flutter ( 24/33 [ 73 % ] versus 11/31 [ 35 % ] ; P=0.005 ) and gap-related macro – re-entrant flutter ( 8/33[24 % ] versus 1/31[3 % ] ; P=0.03 ) . Early recurrence of atrial arrhythmia was an independent predictor of late recurrence . Conclusions —CFAE ablation did not confer incremental benefit when performed in addition to circumferential pulmonary vein ablation and linear ablation . It was associated with a higher incidence of gap-related flutter . Clinical Trial Registration —URL : http://www . clinical trials.gov . Unique identifier : NCT01711047
This review article provides an overview on the published clinical risk scores related to outcomes of rhythm control strategy or AF progression
Patients with atrial fibrillation ( AF ) are commonly managed with rhythm control strategy , but the natural history of this common arrhythmia leads itself to progression from paroxysmal to persistent or permanent AF , and recurrences are evident despite rhythm control treatments using cardioversion or catheter ablation .
Numerous clinical factors have been associated with outcomes of rhythm control or arrhythmia progression in patients with AF .
The more common factors have been used to formulate risk stratification scores , to help predict the outcomes of rhythm control treatments  or AF progression .