Catheter Ablation Success Predictor (APPLE & SUCCESS)

Atrial Fibrillation Type -- choose -- Paroxysmal Persistent Long-standing persistent eGFR (mL/min/1.73m2) Left Atrial Diameter (mm) Left Ventricular Ejection Fraction (%) Number of Prior AF Ablations Catheter Ablation Success Predictor (APPLE & SUCCESS): Explanation and Clinical Context This calculator integrates two validated models—APPLE and SUCCESS—to predict the likelihood of atrial fibrillation (AF) recurrence after catheter ablation. The APPLE score assigns one point for each of the following: age > 65 years, persistent or long-standing persistent AF, impaired renal function (eGFR < 60 mL/min/1.73m2), left atrial diameter ≥ 43 mm, and left ventricular ejection fraction < 50%. The SUCCESS score extends APPLE by adding one additional point for every prior AF ablation, accounting for the increased recurrence risk after repeat procedures.

Clinical Interpretation Summary. APPLE scores of 0 represent low risk, 1–2 intermediate, and ≥3 high risk for post-ablation AF recurrence. The SUCCESS model further refines prediction in patients undergoing multiple ablations.

These models assist in pre-procedural counseling, individualized follow-up intensity, and shared decision-making, though they should not replace clinical judgment. Important Note on “CTOPP”. The term CTOPP historically refers to the Canadian Trial of Physiologic Pacing, unrelated to AF ablation outcome prediction.

The validated predictors for ablation success are APPLE and SUCCESS, as implemented in this calculator.