Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-148 - Disparity In Atrial Fibrillation Therapy (DAFT) Study (ID 1124)

 A.M. Kroman: Nothing relevant to disclose.


Background: Significant disparities remain between recommended treatments for atrial fibrillation (AF) including referral for catheter ablation (CA) across the country and between rural and urban areas.
Objective: To identify trends in AF treatment including CA and individual characteristics of patients seen at University of Washington Medical Center (UWMC).
Methods: This is a retrospective study of patients aged 18 years or older with at least 1 inpatient hospitalization or 1 outpatient visit for a primary diagnosis of AF who received care at UWMC between the years of 2000 to 2018. Patients’ age, gender, race, distance from UWMC, CHADS2-VASc Score, HAS-BLED Score, and whether they received CA for AF. To help account for the changes in the availability of CA, the study period was also divided into two different eras: 2000 to 2013, and 2014 to 2018.
Results: We identified 12,302 patients with AF who met the inclusion criteria. 649 (19%) underwent CA and 11653 (81%) did not. Patients who underwent CA were younger (65.4 ± 12.1 years versus 76.0 ± 14.7 years; p = <0.001, HR 0.98), more likely to be male (70% male, 30% female , p = <0.001, HR 0.69), caucasian (OR for non-white 0.46; p=0.001) to have a lower CHA2DS2-VASc score (1.3±1.1 vs 2.1±1.2, p = <0.001, HR 0.52), and a lower HAS-BLED score (1.3±1.1 versus 1.9±0.9, p = <0.001, HR 1.38). Additionally, it was seen that patients who lived a farther distance from UWMC were more likely to undergo an ablation (mean 63.1±184.6 versus 40.2±203.1 miles, p = <0.001, HR 1.08). By era, the rates of CA increased over time.
Conclusion: Catheter ablation for AF remains an under prescribed treatment with secular and geographical trends and disparities.