Observational studyPacing and clinical electrophysiology : PACE2019
Predicting atrial fibrillation recurrence after ablation in patients with heart failure: Validity of the APPLE and CAAP-AF risk scoring systems.
Observational study in Pacing and clinical electrophysiology : PACE, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Guideline
- 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- A deep learning model integrating structured data and clinical text for predicting atrial fibrillation recurrence.NPJ digital medicine · 2026Article
- The Predictive Value of Real-World Cardiologist Performance (RWCP) Score in Atrial Fibrillation Recurrence Risk After Radiofrequency Ablation.Journal of cardiovascular electrophysiology · 2025Article
- MicroRNAs as Prognostic Biomarkers for Atrial Fibrillation Recurrence After Catheter Ablation: Current Evidence and Future Directions.Biomedicines · 2024Review
- Association between triglyceride-glucose index trajectories and radiofrequency ablation outcomes in patients with stage 3D atrial fibrillation.Cardiovascular diabetology · 2024Article
- New Score for Predicting Results after Catheter Ablation for Atrial Fibrillation: VAT-DHF.Journal of clinical medicine · 2023Article
- Photoplethysmography-Based Machine Learning Approaches for Atrial Fibrillation Prediction: A Report From the Huawei Heart Study.JACC. Asia · 2021Article
- Catheter Ablation of Atrial Fibrillation in Heart Failure: from Evidences to Guidelines.Current heart failure reports · 2021Review
- Serum human epididymis protein 4 levels in the prediction of the recurrence of atrial fibrillation after catheter ablation.Heart and vessels · 2021Article
- Shifts in gut microbiome and metabolome are associated with risk of recurrent atrial fibrillation.Journal of cellular and molecular medicine · 2020Article
Corrections and comments
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Authors and funding
20 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundCompared with medical therapy, catheter ablation of atrial fibrillation (AF) in patients with heart failure (HF) improves cardiovascular outcomes. Risk scores (CAAP-AF and APPLE) have been developed to predict the likelihood of AF recurrence after ablation, have not been validated specifically in patients with AF and HF.
methodsWe analyzed baseline characteristics, risk scores, and rates of AF recurrence 12 months postablation in a cohort of 230 consecutive patients with AF and HF undergoing PVI in the Duke Center for Atrial Fibrillation registry from 2009-2013.
resultsDuring a follow-up period of 12 months, 76 of 230 (33%) patients with HF experienced recurrent AF after ablation. The median APPLE and CAAP-AF scores were 1.5 ([Q1, Q3]: [1.0, 2.0]) and 4.0 ([Q1, Q3]: [3.0, 5.0]), respectively and were not different from those patients with and without recurrent AF. Freedom from AF was not different according to APPLE and CAAP-AF scores. Discrimination for recurrent AF with the CAAP-AF score was modest with a C-statistic of 0.60 (95% CI 0.52-0.67). Discrimination with the APPLE score was similarly modest, with a C-statistic of 0.54 (95% CI: 0.47-0.62).
conclusionsValidated predictive risk scores for recurrent AF after catheter ablation exhibit limited predictive ability in cohorts of AF and HF. Additional tools are needed to facilitate risk stratification and patient selection for AF ablation in patients with concomitant HF.
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