One year outcomes of atrial fibrillation ablation: Contemporary analysis of the United States Nationwide Readmission Database

Lingling Wu, Bharat Narasimhan, Kirtipal Bhatia, Ellen Wu, Pengyang Li, Kam S. Ho, Arti N. Shah, Bharat K. Kantharia

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Data on long-term outcomes of catheter ablation (CA) for atrial fibrillation (AF) in outside of clinical trials settings are sparse. Objective: We aimed to assess outcomes and readmissions at 1 year following admission for CA for AF. Methods: Utilizing the Nationwide Readmissions Database (2016–2018), we identified patients with CA among all patients with a primary admission diagnosis of AF, and a control group by propensity score match adjusted for age, sex, comorbidities, CHA₂DS₂-VASc scores, and the hospital characteristics. The primary outcome was a composite of unplanned heart failure (HF), AF and stroke-related readmissions, and death at 1 year, and secondary outcomes were hospital outcomes and all-cause readmission rates. Results: The study cohort consisted of 29,771 patients undergoing CA and 63,988 controls. Patients undergoing CA were younger with lower CHA₂DS₂-VASc scores and less comorbidities. Over a follow-up of 170 ±1.1 days, the primary outcome occurred in 5.2% in CA group and 6.0% of controls (hazard ratio [HR] and 95% confidence interval [CI]: 0.86 [0.76–0.94], p =.002). CA affected AF and stroke related readmission, but showed no effect on HF and mortality outcome. Male sex (HR: 0.83 [0.74–0.94], p =.03), younger age (HR: 0.71 [0.61–0.83], p <.001], and lower CHA₂DS₂-VASc scores (HR: 0.68 [0.55–0.84], p <.001) were associated with lower risk of primary outcome with CA. Conclusion: In this study, CA for AF was associated with significantly lower AF and stroke-related admissions, but not to HF or all-cause readmission. Better outcomes were seen among males, younger patients, and in patients with less comorbidities and low CHA₂DS₂-VASc scores.

Original languageEnglish
JournalPACE - Pacing and Clinical Electrophysiology
DOIs
StatePublished - Sep 2022

Keywords

  • Agency for Healthcare Research and Quality
  • ICD-10-CM codes
  • atrial fibrillation
  • catheter ablation
  • heart failure
  • readmission
  • stroke

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