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 .
Predicting atrial fibrillation ablation outcome: The CAAP-AF score.
BACKGROUND Patients with a variety of clinical presentations undergo atrial fibrillation ( AF ) ablation .  Long-term ablation success rates can vary considerably . OBJECTIVE The purpose of this study was to develop a clinical scoring system to predict long-term freedom from AF after ablation . METHODS We retrospectively derived the scoring system on a development cohort ( DC ) of 1125 patients undergoing AF ablation  and tested it prospect ively in a test cohort ( TC ) of 937 patients undergoing AF ablation .  RESULTS The demographics of the DC patients were as follows : age 62.3 ± 10.3 years , male sex 801 ( 71.2 % ) , left atrial size 4.30 ± 0.69 cm , paroxysmal AF 348 ( 30.9 % ) , number of drugs failed 1.3 ± 1.1 , hypertension  525 ( 46.7 % ) , diabetes 100 ( 8.9 % ) , prior stroke/transient ischemic attack 78 ( 6.9 % ) , prior cardioversion 528 ( 46.9 % ) , and CHADS2 score 0.87 ± 0.97 . Multivariate analysis showed 6 independent variables predicting freedom from AF after final ablation : coronary artery disease ( P = .021 ) , atrial diameter ( P = .0003 ) , age ( P = .004 ) , persistent or long-st and ing AF ( P < .0001 ) , number of antiarrhythmic drugs failed ( P < .0001 ) , and female sex ( P = .0001 ) . We created a scoring system ( CAAP-AF ) using these 6 variables , with scores ranging from 0 to 13 points . The 2-year AF-free rates by CAAP-AF scores were as follows : 0 = 100 % , 1 = 95.7 % , 2 = 96.3 % , 3 = 83.1 % , 4 = 85.5 % , 5 = 79.9 % , 6 = 76.1 % , 7 = 63.4 % , 8 = 51.1 % , 9 = 53.6 % , and ≥10 = 29.1 % . Ablation success decreased as CAAP-AF scores increased ( P < .0001 ) . The CAAP-AF score also predicted freedom from AF in the TC . The 2-year Kaplan-Meier AF-free rates by CAAP-AF scores were as follows : 0 = 100 % , 1 = 87.0 % , 2 = 89.0 % , 3 = 91.6 % , 4 = 90.5 % , 5 = 84.4 % , 6 = 70.1 % , 7 = 71.0 % , 8 = 60.7 % , 9 = 68.9 % , and ≥10 = 51.3 % . As CAAP-AF scores increased , 2-year freedom from AF in the TC decreased ( P < .0001 ) . CONCLUSION An easily determined clinical scoring system was derived retrospectively and applied prospect ively . The CAAP-AF score predicted freedom from AF after ablation in both a DC and a TC of patients undergoing AF ablation . The CAAP-AF score provides a realistic AF ablation outcome expectation for individual patients
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 .