The HATCH score describes the risk of paroxysmal atrial fibrillation (Afib) progression, while the CHA₂DS₂vasc score depicts the risk of thromboembolic events in patients with Afib. We hypothesized that both scores may predict failure of Afib ablation.

In all, 449 consecutive patients (65.5 % male, mean age 61.7 ± 10.1 years) who presented to our institution for Afib ablation were investigated. A HATCH score of 0, 1, 2, 3, and ≥ 4 was found in 19.6, 50.3, 9.8, 15.6, and 4.6 % of the patients, respectively. A CHA₂DS₂vasc score of 0, 1, 2, 3, 4, 5, and > 5 was found in 10.7, 20.9, 25.1, 20.6, 15.0, 4.7, and 3.0 % of the patients, respectively (mean CHA₂DS₂vasc score, 2.4 ± 1.5). After 618 procedures (1.38 ± 0.55/patient), 84.3 % of patients were free of any atrial arrhythmia after a mean follow-up of 12.7 ± 7.1 months. The freedom of Afib after a single ablation procedure ranged between 50.7 and 60.3 % in patients with HATCH scores between 0 and 3 and dropped to 30.0 % in patients with a HATCH score greater than 3 (p = 0.041). The freedom of Afib after 1.38 procedures per patient ranged between 79.5 % and 88.4 % in patients with a HATCH score between 0 and 3 and was lower with a score of 4 or more (66.7 %, p = 0.064). Pulmonary vein isolation was equally successful in patients with a CHA₂DS₂vasc score of 5 or lower, but less effective in patients with a score greater than 5 (p = 0.013).

Pulmonary vein isolation is equally effective in patients with a low-to-moderate risk of disease progression and thromboembolic risk. However, the success rate seems to decrease in patients with high sores.