{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T06:03:47Z","timestamp":1784527427783,"version":"3.55.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002332","name":"Semmelweis Egyetem","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002332","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Typical atrial flutter (AFL) is associated with considerable morbidity and mortality despite high procedural success rates of cavotricuspid isthmus (CTI) ablation. While the CHA\u2082DS\u2082-VA score is widely used for thromboembolic risk assessment in atrial fibrillation, its prognostic value for long-term survival after CTI ablation remains unclear. Our objective therefore was to evaluate the association between the CHA\u2082DS\u2082-VA score, its individual components, and non-CHA\u2082DS\u2082-VA comorbidities with all-cause mortality following CTI ablation for typical AFL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed clinical and mortality data from 249 consecutive patients who underwent successful CTI ablation between July 2017 and December 2021. Kaplan-Meier survival analysis, Cox regression, and time-dependent ROC analyses were performed to evaluate predictors of all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During a mean follow-up of 1771 \u00b1 635 days, 27% of patients died. Mortality increased progressively with higher CHA\u2082DS\u2082-VA scores, corresponding to a stepwise decline in survival (log-rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). A CHA\u2082DS\u2082-VA score \u22653 was identified as the optimal threshold for mortality prediction, with annual mortality rates of 1.4% versus 9.9% in patients with scores &amp;lt;3 and \u22653, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The CHA\u2082DS\u2082-VA score demonstrated good discriminative ability (c-index\u2009=\u20090.73). In multivariable analysis, the CHA\u2082DS\u2082-VA score remained an independent predictor of all-cause mortality (HR 1.48, 95% CI 1.26 -1.75,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Among non-CHA\u2082DS\u2082-VA variables, pulmonary disease and obstructive sleep apnoea independently predicted adverse long-term survival, whereas female sex was not significantly associated with mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The CHA\u2082DS\u2082-VA score is an independent predictor of long-term all-cause mortality after CTI ablation for typical AFL, extending its clinical utility beyond thromboembolic risk assessment. Incorporation of selected non-CHA\u2082DS\u2082-VA comorbidities may further refine risk stratification and support individualized follow-up strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1884992","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T05:35:56Z","timestamp":1784525756000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["CHA2DS2-VA and non-CHA2DS2-VA components as predictors of mortality after cavotricuspid isthmus ablation: a clinical tool for long-term risk stratification"],"prefix":"10.3389","volume":"13","author":[{"given":"Kamilla Luca","family":"D\u00e1vid","sequence":"first","affiliation":[{"name":"Department of Cardiology, Central Hospital of Northern Pest - Military Hospital","place":["Budapest, Hungary"]},{"name":"Doctoral School of Clinical Medicine, Cardiovascular Medicine and Research Division, Semmelweis University","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"El\u0151d J\u00e1nos","family":"Zsigmond","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Central Hospital of Northern Pest - Military Hospital","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuella","family":"Bogdan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Central Hospital of Northern Pest - Military Hospital","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bal\u00e1zs","family":"Polg\u00e1r","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Central Hospital of Northern Pest - Military Hospital","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolett","family":"Vigh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Central Hospital of Northern Pest - Military Hospital","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zal\u00e1n","family":"Guly\u00e1s","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Central Hospital of Northern Pest - Military Hospital","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Papp","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Central Hospital of Northern Pest - Military Hospital","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emese","family":"T\u00f3th-Zs\u00e1mboki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Central Hospital of Northern Pest - Military Hospital","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e1bor Zolt\u00e1n","family":"Duray","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Central Hospital of Northern Pest - Military Hospital","place":["Budapest, Hungary"]},{"name":"Doctoral School of Clinical Medicine, Cardiovascular Medicine and Research Division, Semmelweis University","place":["Budapest, Hungary"]},{"name":"Heart and Vascular Center, Semmelweis University","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1093\/europace\/euw107","article-title":"Death and thrombo-embolic risk after ablation of atrial flutter compared with atrial fibrillation: a nationwide cohort study","volume":"19","author":"Vadmann","year":"2016","journal-title":"Europace"},{"key":"B2","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.10.025","article-title":"Comparative risks of ischemic stroke in atrial flutter versus atrial fibrillation","volume":"27","author":"Al-Kawaz","year":"2018","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"B3","doi-asserted-by":"publisher","first-page":"11","DOI":"10.31083\/j.rcm2501011","article-title":"Cavotricuspid isthmus-dependent atrial flutter. 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