What question did this study set out to answer?

To compare hospital readmission rates and complications in atrial fibrillation patients undergoing pulsed field ablation with CARTO 3 versus EnSite systems.

January 10, 2026Journal of Comparative Effectiveness Research0 citationsOpen Access

Difference in hospital readmission among patients with atrial fibrillation undergoing ablation using nonintegrated pulsed field catheter with CARTO™ 3 versus EnSite™ electroanatomical mapping system

ACAlexandru CosteaChrist Hospital RKRahul KhannaJohnson & Johnson (United States)MIMaximiliano IglesiasJohnson & Johnson (United States)

Key Result

Patients with atrial fibrillation treated with CARTO 3 had significantly lower 30-day AF-related readmission rates (0.3% vs 0.9%; OR 0.39) compared to those using EnSite.

Key Points

To compare hospital readmission rates and complications in atrial fibrillation patients undergoing pulsed field ablation with CARTO 3 versus EnSite systems.
Analyzed data from the Premier Healthcare Database (2023-2024) on patients treated with nonintegrated pulsed field catheters using either CARTO 3 or EnSite.
Primary outcome assessed was 30-day readmission for AF/AFL/atrial tachycardia.
Secondary outcomes included 30-day cardiovascular-related readmissions and complications.
Cohorts were balanced using inverse probability of treatment weighting.
Descriptive analyses and a weighted Generalized Estimating Equation model evaluated outcome differences.
CARTO 3 group had a 0.3% readmission rate for AF/AFL/atrial tachycardia versus 0.9% in the EnSite group (p = 0.023).
CARTO 3 patients also showed 0.5% in composite readmissions or ER visits compared to 1.1% for EnSite (p = 0.020).
Odds ratio for readmission in CARTO 3 group was 0.39 (95% CI, 0.17–0.90).
No significant differences were found in cardiovascular-related readmissions or complications.

Structured PICO

Does pulsed field ablation using the CARTO 3 mapping system reduce 30-day arrhythmia-related readmissions and ER visits compared to the EnSite system in patients with atrial fibrillation?

Population

4,909 patients with atrial fibrillation undergoing pulsed field ablation using nonintegrated pulsed field catheters, identified from the 2023–2024 Premier Healthcare Database.

Intervention

Pulsed field ablation using the CARTO 3 electroanatomical mapping system

Comparator

Pulsed field ablation using the EnSite electroanatomical mapping system

Outcome

30-day inpatient readmission and emergency room (ER) visit for AF/atrial flutter (AFL)/atrial tachycardia following the index PFA procedurecomposite

In patients undergoing pulsed field ablation for atrial fibrillation, the use of the CARTO 3 mapping system was associated with lower 30-day arrhythmia-related readmissions and ER visits compared to the EnSite system.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Aim: Pulsed field ablation (PFA) is a minimally thermal alternative to traditional thermal catheter ablation for atrial fibrillation (AF), with comparable efficacy and minimal risk of collateral tissue injury. Three-dimensional (3D) electroanatomical mapping systems have been adopted with nonintegrated PFA catheters to improve precision and procedural efficiency. This study compared arrhythmia-related hospital readmissions and procedure-related complications among patients with AF treated with PFA, using either the CARTO™ 3 or EnSite™ electroanatomical mapping system. Materials odds ratio OR, 0.39; 95% CI, 0.17–0.90, GEE p = 0.028) and a composite outcome of AF/AFL/atrial tachycardia-related inpatient readmission or ER visits (0.5% vs 1.1%, chi-square p = 0.020; OR: 0.44, 95% CI: 0.21–0.89, GEE p = 0.023) within 30 days of PFA procedure than the EnSite group. No differences were observed in cardiovascular-related readmission or complications. Conclusion: In this retrospective, real-world study, patients with AF who underwent PFA using CARTO 3 had lower 30-day AF/AFL/atrial tachycardia-related readmissions rates than those treated with EnSite suggesting that choice of mapping system may influence early AF outcomes and could translate into reduced downstream hospitalizations and resource use.

Ask AI

Helpful

Bookmark

View Full Paper