Key result
THERMOCOOL ST/STSF with CARTO 3 is linked to ~20% lower readmission versus TactiCath for AF ablation.
Why the study?
RF catheters with contact force sensing and electroanatomical mapping systems enable individualized catheter ablation for AF, but differences in hospital readmissions between specific catheter and mapping system combinations required examination.
Does THERMOCOOL ST/STSF catheter with CARTO 3 system reduce inpatient readmissions in patients undergoing catheter ablation for atrial fibrillation compared to TactiCath catheter with EnSite system?
Observational (n=15,518)
Yes
Does THERMOCOOL ST/STSF catheter with CARTO 3 system reduce inpatient readmissions in patients undergoing catheter ablation for atrial fibrillation compared to TactiCath catheter with EnSite system?
Effect estimate: OR 0.80 (95% CI 0.66-0.96)
Absolute Event Rate: 7.8% vs 9.3%
p-value: p=0.019
The use of THERMOCOOL ST/STSF with CARTO 3 for atrial fibrillation ablation is associated with significantly lower risks of all-cause and cardiovascular-related hospital readmissions compared to TactiCath with EnSite.
Associated with fewer readmissions after AF ablation; leaves open whether technology choice affects outcomes in randomized trials.
Aim: Radiofrequency (RF) catheter ablation (CA) is a mainstay treatment for atrial fibrillation (AF). RF catheters with contact force (CF) sensing technology and electroanatomical mapping systems enable real-time assessment of catheter tip-tissue interface CF, facilitating individualized and precise CA. This study examined inpatient hospital readmissions in patients with AF treated with THERMOCOOL™ ST/ THERMOCOOL™ STSF catheter with the CARTO™ 3 System versus TactiCath™ catheter with the EnSite™ System. Materials & methods: Patients undergoing CA for AF between 1 July 2019 to 30 November 2021 were identified from the Premier Healthcare Database and grouped based on use of THERMOCOOL ST/STSF or TactiCath™. Study outcomes were all-cause, cardiovascular (CV)-, and AF-related inpatient readmission at 91–365-day post-CA. Inverse probability of treatment weighting of propensity scores balanced baseline patient, comorbidity and hospital characteristics. A weighted generalized estimating equation (GEE) model examined differences in readmission outcomes. Results: A total of 15,518 patients met inclusion criteria (THERMOCOOL ST/STSF, n = 13,001; TactiCath™, n = 2517). Patient characteristics were generally well-balanced after weighting. Patients treated with THERMOCOOL ST/STSF + CARTO 3 had a 20% lower likelihood of all-cause inpatient readmissions (7.8 vs 9.3%, chi-square p = 0.041; odds ratio [OR]: 0.80, 95% confidence interval [CI]: 0.66–0.96, GEE p = 0.019) and a 21% lower likelihood of CV-related inpatient readmission (5.2 vs 6.2%, chi-square p = 0.133, OR: 0.79, 95% CI: 0.62–0.99, GEE p = 0.043) in 91–365-days post-CA versus those treated with TactiCath™ + Ensite. No significant differences were observed for AF-related readmissions. Conclusion: Patients undergoing CA for AF treated with THERMOCOOL ST/STSF + CARTO 3 had a significantly lower risk of all-cause and CV-related inpatient hospital readmission versus those treated with TactiCath™ + Ensite.
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Costea et al. (2024) conducted an observational in Atrial fibrillation (n=15,518). THERMOCOOL ST/STSF catheter with CARTO 3 System vs. TactiCath catheter with EnSite System was evaluated on All-cause inpatient readmission at 91-365 days post-catheter ablation (OR 0.80, 95% CI 0.66-0.96, p=0.019). Catheter ablation for atrial fibrillation using THERMOCOOL ST/STSF with CARTO 3 lowered the likelihood of all-cause inpatient readmission versus TactiCath with EnSite (7.8% vs 9.3%; OR 0.80; P=0.019).
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