Kosiuk et al developed a score for identifying a patient with a left atrial arrhythmogenic substrate. A low-voltage left atrial area may be associated with atrial fibrillation and can predict recurrence of AF after catheter ablation. The authors are from multiple institutions in Europe.
Parameters:
(1) diabetes mellitus (D)
(2) renal dysfunction (R)
(3) fibrillation (F): persistent form of atrial fibrillation
(4) left atrium diameter (L)
(5) age (A)
(6) sex (S)
(7) hypertension (H)
Parameter
Finding
Points
diabetes mellitus
absent
0
present
1
renal dysfunction
absent
0
present
1
persistent atrial fibrillation
absent
0
present
1
left atrial diameter
<= 45 mm
0
> 45 mm
1
age
<= 65 years
0
> 65 yearas
1
sex
male
0
female
1
hypertension
absent
0
present
1
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• A score > 3 was the optimal cutoff for prediction of left atrial low voltage areas. The risk increases as the score increases.
Performance:
• The area under the ROC curve (c statistic) is 0.8.
• At a cutoff > 3 the sensitivity was 76% and specificity 73%.
• The positive predictive value was 53% and negative predictive value 88%.
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