{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:49:32Z","timestamp":1755794972075,"version":"3.44.0"},"reference-count":23,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T00:00:00Z","timestamp":1627948800000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2021,7,13]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The clinical effectiveness of ablating non-paroxysmal atrial fibrillation (non-PAF) relies on proper patient selection. We developed and validated a scoring system to predict non-PAF ablation outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data on 416 non-PAF ablations were analysed using binary logistic regression at a London centre. Identified preprocedural variables, which independently predicted freedom from atrial tachyarrhythmia. Twenty-one possible predictive variables and a model with c-statistic 0.751\u2014explained outcome variation in London at mean follow-up 12\u00b13 months. An additive point score (range 0\u20139) was developed\u2014the FLAME score: female=1; long-lasting persistent atrial fibrillation=1; left atrial diameter in mm: 40 to &lt;45 = 1, 45 to &lt;50 = 2, 50 to &lt;55=3, \u226555 =4; mitral regurgitation (MR) mild to moderate=1; extreme comorbidity=2. Extreme comorbidities include severe MR, moderate mitral stenosis, mitral replacement, hypertrophic cardiomyopathy or congenital heart disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The FLAME score was applied to data (882 non-PAF ablations) at a Californian centre, and predicted the outcome of both single (p&lt;0.0001) and multiple (p&lt;0.0001) procedures. For first ablation (follow-up 2.1 years (median, IQR 1.0\u20134.1)), FLAME score: 0\u20131 predicts 62% success, 2\u20134 44% and \u22655 29% (P<jats:sub>trend<\/jats:sub> &lt;0.0001). After the final ablation (mean procedures: 1.4\u00b10.6, follow-up 1.8 years (median, IQR 0.8\u20133.6)), FLAME score: 0\u20131 predicts 81% success, 2\u20134 65% and \u22655 44% (P<jats:sub>trend<\/jats:sub> &lt;0.0001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>FLAME score is easily calculated, derived in London, and predicted single and multiple procedural outcomes for non-PAF ablations in California. In patients with a high score, even multiple procedures are usually ineffective.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2021-001653","type":"journal-article","created":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T12:47:04Z","timestamp":1628081224000},"page":"e001653","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Internationally validated score to predict the outcome of non-paroxysmal atrial fibrillation ablation: the \u2018FLAME score\u2019"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0285-171X","authenticated-orcid":false,"given":"Vennela","family":"Boyalla","sequence":"first","affiliation":[{"name":"Heart Division, Royal Brompton and Harefield Hospitals, London, UK"},{"name":"National Heart & Lung Institute, Imperial College London, London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian W E","family":"Jarman","sequence":"additional","affiliation":[{"name":"Heart Division, Royal Brompton and Harefield Hospitals, London, UK"},{"name":"National Heart & Lung Institute, Imperial College London, London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vias","family":"Markides","sequence":"additional","affiliation":[{"name":"Heart Division, Royal Brompton and Harefield Hospitals, London, UK"},{"name":"National Heart & Lung Institute, Imperial College London, London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wajid","family":"Hussain","sequence":"additional","affiliation":[{"name":"Heart Division, Royal Brompton and Harefield Hospitals, London, UK"},{"name":"National Heart & Lung Institute, Imperial College London, London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Wong","sequence":"additional","affiliation":[{"name":"Heart Division, Royal Brompton and Harefield Hospitals, London, UK"},{"name":"National Heart & Lung Institute, Imperial College London, London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R Hardwin","family":"Mead","sequence":"additional","affiliation":[{"name":"Silicon Valley Cardiology, East Palo Alto, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Engel","sequence":"additional","affiliation":[{"name":"Silicon Valley Cardiology, East Palo Alto, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa H","family":"Kong","sequence":"additional","affiliation":[{"name":"Silicon Valley Cardiology, East Palo Alto, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rob A","family":"Patrawala","sequence":"additional","affiliation":[{"name":"Silicon Valley Cardiology, East Palo Alto, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger 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