Among 76,219 patients undergoing atrial fibrillation ablation, successful pulmonary vein isolation was achieved in 92.4%, with a 2.50% overall complication rate and 0.05% in-hospital mortality.
Cohort (n=76,219)
Yes
Real-world data from the large-scale NCDR AFib Ablation Registry demonstrates that AF ablation has a high procedural success rate (92.4%) and a low rate of major in-hospital complications (0.9%).
BACKGROUND The National Cardiovascular Data Registry (NCDR) AFib Ablation Registry was created to assess real-world prevalence, demographic characteristics, procedural management, and outcomes of patients undergoing atrial fibrillation (AF) ablation procedures. OBJECTIVES The goal of this study was to characterize the patient, hospital, and physician characteristics and in-hospital outcomes related to AF ablation in the first 5 years of the registry. METHODS This paper describes the AFib Ablation Registry structure and governance, outcome assessment processes, data quality, and data collection processes. The characteristics of the patient population, hospitals, and in-hospital outcomes are also described. RESULTS A total of 76,219 patients were included in the registry between January 2016 and December 2020 (mean age 65.5 ± 10.3 years, 65.2% male, 55.8% paroxysmal AF, mean CHA2DS2-VASc score 2.7 ± 1.6) treated by 708 physicians in 162 hospitals. Successful isolation of all pulmonary veins was achieved in 92.4% of patients. The prevalence of any complication during procedural admission was 2.50% and major complication was 0.9%, including significant bradycardia in 0.47%, heart failure in 0.47%, and pericardial effusion requiring intervention in 0.44%. Hospitalization >1 day occurred in 11.8% of patients, and in-hospital death was rare (n = 41 0.05%). CONCLUSIONS The NCDR AFib Ablation Registry is the largest multicenter, prospective cohort study of patients undergoing catheter ablation worldwide. Results in the first 5 years showed that successful pulmonary vein isolation is achieved in the majority of patients, with a low rate of complications. Future studies from the registry will assess practice trends, evaluate treatment patterns associated with different patient outcomes, and support development of evidence-based guidelines.
“I felt strongly it was a superior treatment option. But you can't rely solely on personal experience. You need research. And the data from various clinical trials didn't cover the majority of patients. We needed to create a comprehensive database to allow us to fully analyze the effectiveness and safety of the procedure.”
Hsu et al. (Mon,) conducted a cohort in Atrial fibrillation (n=76,219). Atrial fibrillation ablation was evaluated on Successful isolation of all pulmonary veins. Among 76,219 patients undergoing atrial fibrillation ablation, successful pulmonary vein isolation was achieved in 92.4%, with a 2.50% overall complication rate and 0.05% in-hospital mortality.