The Predictive Value of Real-World Cardiologist Performance (RWCP) Score in Atrial Fibrillation Recurrence Risk After Radiofrequency Ablation.

IF 2.6 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Electrophysiology Pub Date : 2025-08-19 DOI:10.1111/jce.70067

Yangyang Wang, Jingchao He, Yang Shao, Tong Liu, Aolin Ding, Guohua Xue, Yubing Guo, Pengyu Wu, Yunfei Gu, Hao Wang

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引用次数: 0

Abstract

Objective: To explore the predictive value of Real-world Cardiologist Performance (RWCP) score for atrial fibrillation (AF) recurrence risk after radiofrequency catheter ablation (RFCA).

Methods: Patients with nonvalvular AF who underwent first-time RFCA at Luoyang Central Hospital affiliated to Zhengzhou University between October 2021 and June 2023 were included in this study. Detailed ablation data were exported from CARTO®3 system (Biosense Webster, USA), based on which, four parameters, including discharge time proportion, Catheter Contact Force Stability (C3-FOT proportion), Ablation Index Consistency (SURPOINT/TOP-4 proportion) and fragmented points proportion, were calculated. Then, the RWCP score was calculated from these parameters for each patient. Predictive value of the RWCP score for AF recurrence risk were assessed using Cox regression and Kaplan-Meier analyses.

Results: A total of 148 AF patients were enrolled, including 68 males and 80 females. During follow-up, 30 patients (20.3%) experienced AF recurrence. The RWCP score was calculated using Cox regression coefficients: RWCP score = (left ring discharge time ratio × 2.853) - (left C3-FOT proportion × 0.91) + (left SURPOINT/TOP4 × 2.943) + (left fragmented points proportion × 0.423) - (right ring discharge time ratio × 4.039) - (right C3-FOT proportion × 6.159) - (right SURPOINT/TOP4 × 1.312) - (right points fragmented proportion × 4.425). It was found that patients with higher RWCP scores (-12.53 to 5.79) had higher recurrence risk than those with low scores (-28.68 to -12.76) (HR = 5.55, 95% CI: 2.23-13.80, p = 0.0002). Kaplan-Meier analysis confirmed this (p_log-rank < 0.001). To simplify the operation of RWCP, an online calculator was explored using shiny platform (https://doctorwanghao.shinyapps.io/RWCP_English/).

Conclusion: The RWCP score shows promise as a tool for evaluating ablation completeness, assessing cardiologist performance and predicting AF recurrence risk after ablation.

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真实世界心脏病专家表现（RWCP）评分对射频消融后房颤复发风险的预测价值

目的：探讨Real-world Cardiologist Performance （RWCP）评分对射频导管消融（RFCA）后房颤（AF）复发风险的预测价值。方法：本研究纳入2021年10月至2023年6月在郑州大学附属洛阳中心医院首次行RFCA的非瓣膜性房颤患者。从CARTO®3系统（Biosense Webster， USA）导出详细的消融数据，并在此基础上计算4个参数，包括放电时间比例、导管接触力稳定性（C3-FOT比例）、消融指数一致性（SURPOINT/TOP-4比例）和碎片点比例。然后，根据这些参数计算每位患者的RWCP评分。采用Cox回归和Kaplan-Meier分析评估RWCP评分对房颤复发风险的预测价值。结果：共纳入148例房颤患者，其中男性68例，女性80例。随访期间，30例（20.3%）发生房颤复发。采用Cox回归系数计算RWCP评分：RWCP评分=（左环放电时间比× 2.853） -（左C3-FOT比例× 0.91） +（左SURPOINT/TOP4 × 2.943） +（左碎片点比例× 0.423） -（右环放电时间比× 4.039） -（右C3-FOT比例× 6.159） -（右SURPOINT/TOP4 × 1.312） -（右碎片点比例× 4.425）。RWCP评分较高的患者（-12.53 ~ 5.79）的复发风险高于评分较低的患者（-28.68 ~ -12.76）（HR = 5.55, 95% CI: 2.23 ~ 13.80, p = 0.0002）。Kaplan-Meier分析证实了这一结论（plog-rank）： RWCP评分有望作为评估消融完整性、评估心脏科医生表现和预测消融后房颤复发风险的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiovascular Electrophysiology 医学-心血管系统

CiteScore

5.20

自引率

14.80%

发文量

433

审稿时长

3-6 weeks

期刊介绍： Journal of Cardiovascular Electrophysiology (JCE) keeps its readership well informed of the latest developments in the study and management of arrhythmic disorders. Edited by Bradley P. Knight, M.D., and a distinguished international editorial board, JCE is the leading journal devoted to the study of the electrophysiology of the heart.