Open AccessComparison of procedural outcomes in patients undergoing catheter vs surgical ablation for atrial fibrillation and heart failure with reduced ejection fraction
Author(s) -
Doshi Rajkumar,
Kumar Ashish,
Shariff Mariam,
Adalja Devina,
Patel Krunalkumar,
Patel Kirtenkumar,
Desai Rupak,
Gullapalli Nageshwara,
Vallabhajosyula Saraschandra
Publication year - 2021
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1002/joa3.12451
Subject(s) - medicine , atrial fibrillation , ejection fraction , heart failure , catheter ablation , cardiology , propensity score matching , adverse effect , ablation
Abstract Background There is a lack of research comparing procedural outcomes of surgical ablation (SA) and catheter ablation (CA) among patients with heart failure with reduced ejection fraction (HFrEF) and atrial fibrillation (AF). The main objective was to compare the short‐term procedural outcomes of SA and CA in patients with HFrEF. Methods We used the national inpatient sample to identify hospitalizations over 18 years with HFrEF hospitalization and AF, and undergoing SA and CA from 2016 to 2017. Furthermore, the clinical outcomes of SA vs CA in AF stratified as nonparoxysmal and paroxysmal were analyzed. Results A total of 1,770 HFrEF hospitalizations with AF who underwent SA and 1,620 HFrEF hospitalizations with AF who underwent CA were included in the analysis. Hospitalizations with CA had higher baseline comorbidities. The in‐hospital mortality among HFrEF with AF undergoing SA as compared with CA was similar (2.8% vs 1.9%, respectively, adjusted P‐value 0.09). Hospitalizations with SA had a significantly longer length of hospital stay, a higher percentage of postprocedural, and cardiac complications. In HFrEF hospitalizations with nonparoxysmal AF, SA as compared with CA was associated with a higher percentage of in‐hospital mortality (2.4% vs 1%, adjusted P ‐value <.05), a longer length of stay, a higher cost of treatment, and a higher percentage of cardiac complications. Conclusion CA is associated with lower in‐hospital adverse procedural outcomes as compared with SA among HFrEF hospitalizations with AF. Further research with freedom from AF as one of the outcome is needed between two groups for HFrEF.