Key result
AF ablation in mechanical valve patients shows similar peri-procedural complication rates to matched controls.
Why the study?
Catheter ablation for AF has been increasingly utilized, but nationwide trends in its utilization and procedural complications in patients with mechanical prosthetic valves required investigation.
Does catheter ablation for atrial fibrillation have a similar risk of procedural complications and mortality in patients with mechanical prosthetic valves compared to those without?
Cohort (n=3,799)
Yes
Does catheter ablation for atrial fibrillation have a similar risk of procedural complications and mortality in patients with mechanical prosthetic valves compared to those without?
Absolute Event Rate: 8.4% vs 10.4%
p-value: p=.33
Catheter ablation for atrial fibrillation in patients with mechanical prosthetic valves appears to have a similar safety profile regarding periprocedural complications and in-hospital mortality compared to patients without prosthetic valves.
Supports similar periprocedural safety for AF ablation in mechanical valve patients; observational data leave randomized confirmation open.
BACKGROUND: Catheter ablation (CA) for atrial fibrillation (AF) is increasingly utilized in recent years, with promising results. We aimed to investigate the nationwide trends in utilization and procedural complications of CA for AF in patients with mechanical prosthetic valves (MPVs). METHODS AND RESULTS: We drew data from the US National Inpatient Sample (NIS) database to identify cases of AF ablations in patients with MPVs, between 2003 and 2015. Sociodemographic and clinical data were collected, and incidence of procedural complications, mortality, and length of stay were analyzed. We compared the outcomes to a propensity-matched cohort of patients without MPVs. The study included a weighted total of 1898 CA for AF cases in patients with MPVs. The median age of the study population was 67 (61-75) years and 53% were males. Despite the increasing age and significant uptrend in the prevalence of individual comorbidities and Deyo-Charlson Comorbidity Index (CCI) over the years, the risk of peri-procedural complications and mortality in the study group did not change between the early (2003-2008) and late (2009-2015) study years. The peri-procedural complication rate (8.4% vs. 10.4%, p = .33) and in-hospital mortality (0.2% vs. 0.2%, p = .9) did not differ significantly between patients with MPVs and 1901 matched patients without MPVs. Length of stay was higher among patients with prior MPVs compared to the controls (4.0 ± 0.2 vs. 3.3 ± 0.2 days, p = .011). CONCLUSION: This nationwide analysis shows that AF ablation in patients with mechanical valve prothesis bares a similar risk of periprocedural complications and mortality as in patients without prosthetic valves.
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Rozen et al. (2022) conducted a cohort in Atrial fibrillation (n=3,799). Catheter ablation vs. Patients without mechanical prosthetic valves was evaluated on Peri-procedural complication rate (p=.33). Catheter ablation for atrial fibrillation in patients with mechanical valves had similar peri-procedural complication rates as matched controls without mechanical valves (8.4% vs 10.4%, p=0.33).
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