Catheter ablation for atrial fibrillation was associated with a lower risk of unplanned heart failure, AF, stroke-related readmissions, and death (HR 0.86; 95% CI 0.76-0.94; p=0.002).
Observational (n=93,759)
Yes
Does catheter ablation reduce unplanned heart failure, AF, stroke-related readmissions, and death at 1 year in patients admitted for atrial fibrillation?
Catheter ablation for atrial fibrillation is associated with a significantly lower risk of AF and stroke-related readmissions compared to medical management, with the greatest benefit seen in younger males with fewer comorbidities.
Effect estimate: HR 0.86 (95% CI 0.76-0.94)
Absolute Event Rate: 5.2% vs 6%
p-value: p=0.002
BACKGROUND: Data on long-term outcomes of catheter ablation (CA) for atrial fibrillation (AF) in outside of clinical trials settings are sparse. OBJECTIVE: We aimed to assess outcomes and readmissions at 1 year following admission for CA for AF. METHODS: Utilizing the Nationwide Readmissions Database (2016-2018), we identified patients with CA among all patients with a primary admission diagnosis of AF, and a control group by propensity score match adjusted for age, sex, comorbidities, CHA₂DS₂-VASc scores, and the hospital characteristics. The primary outcome was a composite of unplanned heart failure (HF), AF and stroke-related readmissions, and death at 1 year, and secondary outcomes were hospital outcomes and all-cause readmission rates. RESULTS: The study cohort consisted of 29,771 patients undergoing CA and 63,988 controls. Patients undergoing CA were younger with lower CHA₂DS₂-VASc scores and less comorbidities. Over a follow-up of 170 ±1.1 days, the primary outcome occurred in 5.2% in CA group and 6.0% of controls (hazard ratio HR and 95% confidence interval CI: 0.86 0.76-0.94, p = .002). CA affected AF and stroke related readmission, but showed no effect on HF and mortality outcome. Male sex (HR: 0.83 0.74-0.94, p = .03), younger age (HR: 0.71 0.61-0.83, p < .001], and lower CHA₂DS₂-VASc scores (HR: 0.68 0.55-0.84, p < .001) were associated with lower risk of primary outcome with CA. CONCLUSION: In this study, CA for AF was associated with significantly lower AF and stroke-related admissions, but not to HF or all-cause readmission. Better outcomes were seen among males, younger patients, and in patients with less comorbidities and low CHA₂DS₂-VASc scores.
Wu et al. (Fri,) conducted a observational in Atrial fibrillation (n=93,759). Catheter ablation vs. Propensity score matched controls was evaluated on Composite of unplanned heart failure (HF), AF and stroke-related readmissions, and death at 1 year (HR 0.86, 95% CI 0.76-0.94, p=0.002). Catheter ablation for atrial fibrillation was associated with a lower risk of unplanned heart failure, AF, stroke-related readmissions, and death (HR 0.86; 95% CI 0.76-0.94; p=0.002).