Key result
High comorbidity burden linked to ~82% higher complication rates during inpatient AF ablation.
Why the study?
AF ablation success rates have not substantially improved despite technical advances, and treating patients with advanced age and higher comorbidities may limit success while increasing complications.
Does high comorbidity burden increase in-hospital complications and mortality in patients undergoing inpatient catheter ablation for atrial fibrillation?
Observational (n=64,995)
Yes
Does high comorbidity burden increase in-hospital complications and mortality in patients undergoing inpatient catheter ablation for atrial fibrillation?
Absolute Event Rate: 14.2% vs 7.8%
p-value: p=<0.001
The proportion of patients with high comorbidity burden undergoing inpatient catheter ablation for atrial fibrillation nearly doubled from 2016 to 2021, and this higher burden is associated with significantly increased in-hospital mortality and complications.
BACKGROUND: Despite advancements in catheter ablation (CA) technique and expertise, success rates of atrial fibrillation (AF) ablation have not substantially improved in recent years. Treating patients with advanced age and higher comorbidities may limit success rates while increasing complications. OBJECTIVE: To evaluate trends in comorbidity burden and its association with in-hospital outcomes following inpatient CA procedures for AF. METHODS: Using the National Inpatient Sample database, an estimated total of 64,995 CA procedures for AF between 2016 and 2021 in the United States were analyzed. Each patient's comorbidities were identified, and their comorbidity burden was evaluated using a standardized comorbidity index. In-hospital outcomes were compared between patients with high and low comorbidity burdens. Annual trends in the rates of patients with high comorbidity burden were calculated. RESULTS: A total of 11,685 (18.0%) patients had high comorbidity burden. The annual trend in CA procedures for patients with high comorbidity burden gradually increased from 11.7% in 2016 to 22.1% in 2021 (p < 0.001). A higher rate of total complications was observed in patients with high comorbidity burden (14.2% vs. 7.8%, p < 0.001), driven by vascular, infectious, and respiratory complications, but not by cardiac complications. In-hospital mortality was significantly higher among those with a high comorbidity burden (1.5% vs. 0.2%, p < 0.001). CONCLUSION: In recent years, inpatient CA for AF has increasingly been performed in patients with higher comorbidity burden. A careful preprocedural risk-benefit assessment would be prudent in patients with high comorbidity burden to improve outcomes.
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Leshem‐Rubinow et al. (2026) conducted an observational in Atrial fibrillation (n=64,995). High comorbidity burden vs. Low comorbidity burden was evaluated on Total complications (p=<0.001). High comorbidity burden in patients undergoing inpatient atrial fibrillation catheter ablation was associated with higher rates of total complications (14.2% vs. 7.8%, p<0.001).
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