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

D-PO03-165 - Catheter Ablation Versus Medical Therapy For Atrial Fibrillation Among Patients With Heart Failure In The United States: Propensity Matched Analysis Of The Nationwide Readmissions Database (ID 1134)

 F.V. Lima: Nothing relevant to disclose.


Background: Catheter ablation (CA) for symptomatic atrial fibrillation (AF) in heart failure (HF) has shown improvement in quality of life and long-term mortality. Contemporary nationwide data on 30-day readmission (30DR) following CA compared to medical therapy (MT) for AF in HF patients are limited.
Objective: We aimed to compare the 30DR rates, predictors, costs, and length of stay (LOS) of CA and MT among patients with AF and HF.
Methods: Patients were screened from the 2016 Nationwide Readmissions Databases. Propensity score (PS) matching was used to balance baseline clinical characteristics. Multivariable regression models were used to identify independent predictors of 30DR.
Results: Overall, 749,776 (national estimate of 1,421,673) patients with HF and AF were identified before PS matching. Of these, 2,204 underwent CA. Crude 30DR rates were lower for patients treated with CA than MT (16.8% vs 20.1%, p<0.001), and these differences continued in the PS matched cohort (n=24,244; 16.6% vs 18.8%, p=0.02). Treatment with CA vs MT was associated with significantly lower 30DR in multivariable analysis (OR 0.86 [95% CI 0.77-0.97]. Predictors of 30DR included comorbidities, public insurance, and discharge disposition. Days to readmission were shorter for CA than MT (9 vs 11, p=0.05), but this was negated after PS matching. Although index hospitalization costs and LOS were higher for CA, readmission costs and LOS were similar before and after PS matching.
Conclusion: In a national analysis of patients with AF and HF, CA had lower rates and odds for 30DR compared to MT. When readmitted, CA had lower costs and LOS.