Association of Paroxysmal Versus Persistent Atrial Fibrillation with In-hospital Outcomes and 30-day Readmission After Inpatient Atrial Fibrillation Ablation

Min Choon Tan; Yong Hao Yeo; Qi Xuan Ang; Bryan E-Xin Tan; Jian Liang Tan; Pattara Rattanawong; Joaquim Correia; Aneesh Tolat

doi:10.19102/icrm.2024.15066

Association of Paroxysmal Versus Persistent Atrial Fibrillation with In-hospital Outcomes and 30-day Readmission After Inpatient Atrial Fibrillation Ablation

J Innov Card Rhythm Manag. 2024 Jun 15;15(6):5894-5901. doi: 10.19102/icrm.2024.15066. eCollection 2024 Jun.

Authors

Min Choon Tan^{1

2}, Yong Hao Yeo³, Qi Xuan Ang⁴, Bryan E-Xin Tan⁵, Jian Liang Tan⁶, Pattara Rattanawong⁷, Joaquim Correia⁸, Aneesh Tolat⁹

Affiliations

¹ Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, NJ, USA.
² Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, USA.
³ Department of Internal Medicine/Pediatrics, Beaumont Health, Royal Oak, MI, USA.
⁴ Department of Internal Medicine, Sparrow Health System and Michigan State University, East Lansing, MI, USA.
⁵ Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
⁶ Department of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
⁷ Demoulas Center for Cardiac Arrhythmias, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁸ Department of Cardiovascular Medicine, New York Medical College at Saint Michael's Medical Center, Newark, NJ, USA.
⁹ Department of Cardiovascular Medicine, Hartford Healthcare/University of Connecticut, Hartford, CT, USA.

Abstract

Knowledge of the impact of paroxysmal and persistent atrial fibrillation (AF) after catheter ablation on in-hospital outcomes and 30-day readmission remains limited. This study aimed to evaluate the procedural outcomes and 30-day readmission rates among patients with paroxysmal or persistent AF who were hospitalized for AF ablation. Using the Nationwide Readmissions Database, our study included patients aged ≥18 years with AF who were hospitalized and underwent catheter ablation during 2017-2020. Then, we compared the in-hospital procedural outcomes and 30-day readmission rates between patients with paroxysmal and persistent AF, respectively. Our study included 7310 index admissions for paroxysmal AF ablation and 9179 index admissions for persistent AF ablation. According to our analysis, there was no significant difference in procedural complications-namely, cerebrovascular accident, vascular complications, major bleeding requiring blood transfusion, phrenic nerve palsy, pericardial complications, and systemic embolization-between the persistent and paroxysmal AF groups. There was also no significant difference in early mortality between these groups (0.5% vs. 0.7%; P = .22). Persistent AF patients had significantly higher rates of prolonged index hospitalization (9.9% vs. 7.2%; P < .01) and non-home discharge (4.8% vs. 3.1%; P < .01). The 30-day readmission rates were comparable in both groups (10.0% vs. 9.5%; P = .34), with recurrent AF and heart failure being two of the most common causes of cardiac-related readmissions. Catheter ablation among hospitalized patients with paroxysmal or persistent AF resulted in no significant difference in procedural complications, early mortality, or 30-day readmission. This suggests that catheter ablation of AF can be performed with a relatively similar safety profile for both paroxysmal and persistent AF.

Keywords: Atrial fibrillation; catheter ablation; cause of readmission; hospital outcomes; paroxysmal atrial fibrillation; persistent atrial fibrillation.