The study covered in this summary was published on ResearchSquare.com as a preprint and has not yet been peer reviewed.
Catheter ablation for atrial fibrillation (AF) in adults up to age 50 is associated with reduced risks of hospitalization due to AF or to any cause at 1 year without an apparent effect on 1-year all-cause mortality.
Why This Matters
Catheter ablation for AF in younger adult patients has been shown to be safe and efficacious, with high procedural success rates and low complication rates. Less clear in this population is its effect on clinical outcomes.
The study suggests, consistent with other research, that catheter ablation of AF in adults up to age 50 can lower their risks of all-cause hospitalization and hospitalization for AF and supports the intervention's value in this population.
The observational analysis was based 52,598 patients aged 18 to 50 with a primary or secondary diagnosis of AF who entered the Nationwide Readmission Database (NRD) from 2016 to 2017. The database covers about 17 million discharges in 26 states and accounts for about 58% of all hospitalizations in the United States.
The 2146 patients who underwent catheter ablation for AF and the remainder of the cohort who did not undergo ablation were followed for a median of 183 days for all-cause hospital readmission, AF hospital readmission, ischemic-stroke hospital readmission, and all-cause mortality, all at 1 year.
Patients who underwent catheter ablation, compared to those not receiving ablation, were significantly older and were more likely to be male (P > .001 for both differences).
Rates of AF readmission at 1 year were 5.2% in the ablation group and 9.0% for those without ablation. The corresponding rates for readmission for any cause were 17.2% and 21.3%, respectively.
Adjusted hazard ratios for the ablation group in comparison with those who did not undergo ablation were 0.52 (95% CI, 0.43 – 0.63) for AF readmission and 0.81 (95% CI, 0.72 – 0.89) for all-cause readmission.
There were no significant differences between the two groups in readmission for stroke and for death from any cause at 1 year.
The reduction in the risk for AF readmission was consistent across important subgroups, including groupings by sex, type of third-party payer, hospital size by number of beds, and many cardiovascular comorbidities.
Patients with procedures at teaching hospitals and those with CHA2DS2VASc scores of 4 or less seemed to derive more benefit.
The study was retrospective and was limited to 1-year outcomes for hospitalized patients, excluding patients seen in the primary care setting or in the emergency department, potentially leading to underrepresentation of healthier young adults with AF.
The study relied on ICD codes for identification of patients and clinical outcomes and was therefore subject to potential miscoding.
Data on type of AF and procedural details and more granular patient-level clinical information could not be obtained.
The findings require validation in prospective randomized trials.
The study received no funding.
The authors declared no competing interests.
This is a summary of a preprint research study, "One-Year Outcomes of Catheter Ablation for Atrial Fibrillation in Young Patients," written by Andrew S. Tseng from Mayo Clinic, Minnesota, and colleagues, published on ResearchSquare.com and provided to you by Medscape. This study has not yet been peer reviewed. The full text of the study can be found on ResearchSquare.com.
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Cite this: Eileen Gamagami. Ablation of AF in Younger Adults Cuts Hospital Readmission Risk - Medscape - Jun 14, 2022.