ANTWOORD Score for prediction of recovery of LVEF after catheter ablation of AF in HFrEF

ANTWOORD Score is a novel model for prediction of recovery of left ventricular ejection fraction after catheter ablation in those with atrial fibrillation and heart failure with reduced ejection fraction, based on the ANTWOORD I trial [1]. It is a negative score, meaning that higher score indicates a lower chance of recovery of left ventricular ejection fraction. In the study, absence of known etiology of heart failure, presence of persistent atrial fibrillation, left atrial volume index less than 50 ml per square meter and QRS duration less than 120 milliseconds were the independent predictors of recovery of LVEF.

These were the components of ANTWOORD Score. Patients with score of 1 or less had 90% likelihood of recovery of LVEF, compared to 5% in those with scores 3-6. Presence of known etiology of heart failure and QRS duration of more than 120 ms gave two points each. Paroxysmal AF and severe left atrial dilatation had one point each. That is how the maximum points came to 6.

Reference

1. Bergonti M, Spera F, Tijskens M, Bonomi A, Saenen J, Huybrechts W, Miljoen H, Wittock A, Casella M, Tondo C, Heidbuchel H, Sarkozy A. A new prediction model for left ventricular systolic function recovery after catheter ablation of atrial fibrillation in patients with heart failure: The ANTWOORD Study. Int J Cardiol. 2022 Jul 1;358:45-50. doi: 10.1016/j.ijcard.2022.04.040. Epub 2022 Apr 17. PMID: 35443194.