Validation of the MB-LATER score for prediction of late recurrence after catheter-ablation of atrial fibrillation

Background: Reliable identification of atrial fibrillation (AF) patients more likely to be AF-free long-term post-single catheter ablation (CA) would facilitate appropriate risk communication to patients. We validated the recently proposed MB-LATER score for prediction of late recurrences of AF (LRAF) post-CA. Methods: Patients who underwent CA for symptomatic AF refractory to >= 1 antiarrhythmic drugs at the Johns Hopkins Hospital, Baltimore, between March 2003 and December 2015, for whom >= 1-year post-CA follow-up data were available, were enrolled. Results: Of 226 patients (median age 58.5 years [IQR: 52.0-65.0], 163 males [72.1%], 142 [62.8%] with paroxysmal AF), LRAF occurred in 133 patients (58.8%) during a median 2-year follow-up (IQR: 1.1-4.1). The mean MB-LATER score was significantly higher in patients with versus those without LRAF (2.4 +/- 1.2 vs. 1.9 +/- 1.3, p = 0.002) and showed modest but significant predictive ability for LRAF (AUC: 0.62 [95% CI: 0.54-0.69], p = 0.003). A score cut-off value of >2 showed the best predictive ability for LRAF (70.4% [61.5-77.9]), with modest sensitivity (42.9% [34.3-51.7]) and specificity (74.2% [64.1-82.7]). Kaplan-Meyer survival free from AF was significantly better for patients with a MB-LATER score of >= 2 than for those with a score of N2 (log-rank p = 0.005). Conclusion: In our study, the MB-LATER score showed a significant but modest predictive ability for LRAF post-AF ablation. Further prospective validation is needed to better define the potential role of the MB-LATER score in patient selection and treatment decision-making post-AF ablation. (c) 2018 Published by Elsevier B.V.