Zero-fluoroscopy ablation of paroxysmal atrial fibrillation at community hospitals resulted in lower AF recurrence at 12 months compared to tertiary hospitals (17% vs. 29%, p<0.010).
Cohort (n=290)
Yes
Does zero-fluoroscopy pulmonary vein isolation at community hospitals improve outcomes compared to tertiary hospitals in patients with paroxysmal atrial fibrillation?
Zero-fluoroscopy ablation of paroxysmal atrial fibrillation at community hospitals is safe and associated with shorter diagnosis-to-ablation times and lower early AF recurrence compared to tertiary centers.
Absolute Event Rate: 17% vs 29%
p-value: p=<0.010
BACKGROUND Catheter ablation of atrial fibrillation (AF) is primarily performed at tertiary hospitals (THs). The safety and effectiveness of AF ablation at community hospitals (CHs) remains unclear. OBJECTIVE To assess the long-term efficacy and safety of paroxysmal AF (PAF) ablation at CHs. METHODS We retrospectively analyzed patients evaluated at 2 CHs who underwent zero-fluoroscopy (ZF) pulmonary vein isolation (PVI) at a TH (2015 - 2017) with those ablated at CHs (2017-2021) after implementation of a local ablation program. Patients were followed up for 24 months (m) with event monitors and self-wearable cardiac monitoring devices. Propensity score matching (PSM) yielded two matched cohorts of 290 patients (mean age 66 ± 5 years; 70% male; CHA2DS2-VASc score 1 ± 2; EF 55%). RESULTS No intraprocedural complications or transfers occurred. CH patients had lower AF recurrence at 12 and 18 m (17% vs. 29%, p9 m (HR 3.7; 95% CI, 2.30-3.75) compared with <3 m. CONCLUSIONS Ablation of PAF at CHs with ZF is safe with a shorter DAB and decrease AF recurrences when compared with TH.
Navarrete et al. (2026) conducted a cohort in Paroxysmal atrial fibrillation (n=290). Zero-fluoroscopy pulmonary vein isolation at community hospitals vs. Zero-fluoroscopy pulmonary vein isolation at tertiary hospitals was evaluated on Atrial fibrillation recurrence at 12 months (p=<0.010). Zero-fluoroscopy ablation of paroxysmal atrial fibrillation at community hospitals resulted in lower AF recurrence at 12 months compared to tertiary hospitals (17% vs. 29%, p<0.010).