Author + information
- Received July 23, 2018
- Revision received September 28, 2018
- Accepted October 25, 2018
- Published online December 26, 2018.
- Jia Guo, BS,
- Hemal M. Nayak, MD,
- Stephanie A. Besser, MS,
- Andrew Beaser, MD,
- Zaid Aziz, MD,
- Michael Broman, MD, PhD,
- Cevher Ozcan, MD,
- Roderick Tung, MD and
- Gaurav A. Upadhyay, MD∗ ()
- Center for Arrhythmia Care, Heart and Vascular Center, The University of Chicago Pritzker School of Medicine, The University of Chicago Medicine, Chicago, Illinois
- ↵∗Address for correspondence:
Dr. Gaurav A. Upadhyay, Center for Arrhythmia Care, Heart and Vascular Center, The University of Chicago Pritzker School of Medicine, 5841 South Maryland Avenue, MC 9024, Chicago, Illinois 60637.
Objectives This study assessed the impact of atrial fibrillation (AF) ablation on hospitalization and antiarrhythmic drug use in the community setting.
Background Despite the widespread increase in the use of catheter ablation to treat AF in the United States, the impact of ablation on arrhythmic, cardiovascular, and noncardiovascular hospitalizations remains unclear.
Methods The national prospectively acquired Truven Health MarketScan data set (January 1, 2008 to December 31, 2014) was used to identify patients who underwent first time AF ablation with uninterrupted enrollment for 24 months (12 months pre-ablation and 12 months post-ablation). Multivariate logistic regression was used to determine predictors of hospitalization.
Results Of 5,238 patients who underwent AF ablation for the first time, 2,720 patients with uninterrupted enrollment were analyzed (age 60 ± 10 years; 29% were women, 79% had hypertension, and 23% had heart failure [HF]). AF ablation was associated with significantly reduced all-cause hospitalization from 1,669 hospitalizations in the year before ablation to 1,034 hospitalizations in the year after ablation, which was driven primarily by a 56% reduction in arrhythmic hospitalization. Nonarrhythmic cardiovascular hospitalizations also declined through a 43% drop off in HF hospitalizations. Noncardiovascular hospitalization rates did not significantly change. Age younger than 55 years (odds ratio [OR]: 1.43; p < 0.001), obstructive sleep apnea (OR: 1.38; p < 0.001), and HF (OR: 1.29; p = 0.024) were multivariate predictors for decreased arrhythmic hospitalization. Rates of antiarrhythmic drug use also significantly declined post-procedure by 37.5% (p < 0.001).
Conclusions In this nationwide cohort, AF ablation was associated with significant decreases in arrhythmic and nonarrhythmic cardiovascular hospitalizations, which was driven by reductions in hospitalization for AF and HF.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received July 23, 2018.
- Revision received September 28, 2018.
- Accepted October 25, 2018.
- 2018 American College of Cardiology Foundation
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