Objective:

To evaluate the association between the CHA₂DS₂-VA score, its individual components, and non-CHA₂DS₂-VA comorbidities with all-cause mortality following CTI ablation for typical AFL.

Approach:

• Study Design: Retrospective analysis of clinical and mortality data from 249 patients who underwent successful CTI ablation between July 2017 and December 2021.
• Statistical Analysis: Utilized Kaplan-Meier survival analysis, Cox regression, and time-dependent ROC analyses to evaluate predictors of all-cause mortality.

Key Findings:

• 27% of patients died during a mean follow-up of 1771 ± 635 days.
• Mortality increased with higher CHA₂DS₂-VA scores; a score ≥3 was optimal for mortality prediction.
• Annual mortality rates were 1.4% for scores <3 and 9.9% for scores ≥3 (p < 0.001).
• CHA₂DS₂-VA score showed good discriminative ability (c-index = 0.73).
• CHA₂DS₂-VA score was an independent predictor of all-cause mortality (HR 1.48, 95% CI 1.26 -1.75, p < 0.001).
• Pulmonary disease and obstructive sleep apnoea independently predicted adverse long-term survival.

Interpretation:

Limitations:

• Retrospective design may introduce bias.
• Single-center study limits generalizability.
• Potential confounding factors not accounted for.

Conclusion: