Author + information
- Received April 25, 2011
- Revision received August 22, 2011
- Accepted August 29, 2011
- Published online January 10, 2012.
- Rashmee U. Shah, MD, MS⁎,⁎ (, )
- James V. Freeman, MD, MPH⁎,
- David Shilane, PhD⁎,
- Paul J. Wang, MD⁎,
- Alan S. Go, MD†,‡ and
- Mark A. Hlatky, MD⁎
- ↵⁎Reprint requests and correspondence:
Dr. Rashmee U. Shah, Cedars-Sinai Medical Center, Department of Cardiology, 8700 Beverly Boulevard, Room 5536B, Los Angeles, California 90048
Objectives The purpose of this study was to estimate rates and identify predictors of inpatient complications and 30-day readmissions, as well as repeat hospitalization rates for arrhythmia recurrence following atrial fibrillation (AF) ablation.
Background AF is the most common clinically significant arrhythmia and is associated with increased morbidity and mortality. Radiofrequency or cryotherapy ablation of AF is a relatively new treatment option, and data on post-procedural outcomes in large general populations are limited.
Methods Using data from the California State Inpatient Database, we identified all adult patients who underwent their first AF ablation from 2005 to 2008. We used multivariable logistic regression to identify predictors of complications and/or 30-day readmissions and Kaplan-Meier analyses to estimate rates of all-cause and arrhythmia readmissions.
Results Among 4,156 patients who underwent an initial AF ablation, 5% had periprocedural complications, most commonly vascular, and 9% were readmitted within 30 days. Older age, female, prior AF hospitalizations, and less hospital experience with AF ablation were associated with higher adjusted risk of complications and/or 30-day readmissions. The rate of all-cause hospitalization was 38.5% by 1 year. The rate of readmission for recurrent AF, atrial flutter, and/or repeat ablation was 21.7% by 1 year and 29.6% by 2 years.
Conclusions Periprocedural complications occurred in 1 of 20 patients undergoing AF ablation, and all-cause and arrhythmia-related rehospitalizations were common. Older age, female sex, prior AF hospitalizations, and recent hospital procedure experience were associated with a higher risk of complications and/or 30-day readmission after AF ablation.
This study was funded by a grant from the American Heart Association, Dallas, Texas, National Institutes of Health grant 5UL1RR025744, and Stanford NIH/NCRR CTSA grant KL2RR025743. Dr. Wang has stock ownership in Hansen Medical; and has received honoraria from Medtronic. All other authors have reported that they have no relationships to disclose relevant to the contents of this paper to disclose. The first two authors contributed equally to this work. Bruce D. Lindsay, MD, served as Guest Editor for this paper.
- Received April 25, 2011.
- Revision received August 22, 2011.
- Accepted August 29, 2011.
- American College of Cardiology Foundation