Catheter Ablation for Atrial Fibrillation in Patients With Concurrent Heart Failure
Section snippets
Methods
Nationwide readmission database (NRD) from the year 2016–2017 was utilized to derive the study cohort. NRD is a subset of the Healthcare Cost and Utilization Project (HCUP), sponsored by the Agency for Healthcare Research and Quality. NRD from year 2016–17 contains data from approximately 17 million discharges, across 28 geographically dispersed states, accounts for 60% of the total US resident population and 58.2% of all US hospitalizations.12 NRD was studied and validated in multiple previous
Results
Our study included a total of 119,694 patients from the year 2016–2017 with AF and comorbid HF, in which 63,299 had HFrEF and 56,395 had HFpEF. Of the patients with AF and concomitant HFrEF or HFpEF, 2,841(4.5%) and 1,790 (3.2%) patients respectively underwent AF ablation (Table 1).
In the HFrEF cohort, 42.6% of patients were ≥75 years and 40.2% of patients were female. The most common comorbidities were hypertension (81.4%), CAD (50.2%), diabetes (32.1%), CKD stage 3 or more (27.5%), and COPD
Discussion
In this real-world report of patients with AF and co-morbid HF, the patients who underwent catheter ablation did not demonstrate significant improvement in the primary outcome of all-cause mortality and HF hospitalization when compared with patients who did not receive ablative therapy. AF readmission rates at the end of 1 year were significantly less in patients that underwent catheter ablation in HFrEF and HFpEF. All-cause readmission rates in patients with HFrEF that received ablation were
Author Contributions
Dr. S. Arora: Conceptualization, methodology, software, formal analysis, writing – review and editing, project administration; Dr. Jaswaney: Writing – original draft, writing review- and editing, project administration; Dr. Jani: formal analysis, software; Dr. Zuzek: Writing- original draft, writing- review and editing; Dr. Thakkar: writing – original draft; Dr. H Patel: project administration; Ms. M Patel: visualization, project administration; Dr. N Patel: Project administration; Dr.
Disclosures
The authors of this manuscript have no relevant conflicts of interest to report.
Acknowledgment
There are no further acknowledgements to this paper.
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2022, European Journal of Internal MedicineCitation Excerpt :A further recent contemporary observational study on a German cohort of 414 consecutive HF-AF patients undergoing cryoablation of the pulmonary veins shows that 80% of them had HFpEF (EF ≥ 45%) [42]. Another US administrative registry [43], included 119,694 AF-HF patients. Of these, 63,299 had HFrEF (EF ≤ 50%) and 56,395 HFpEF (EF > 50%).
Outcomes and Resource Utilization of Atrial Fibrillation Hospitalizations With Type 2 Myocardial Infarction
2021, American Journal of CardiologyCitation Excerpt :The ICD-10-CM diagnosis codes I48.0, I48.1, I48.2, I48.91 were utilized to identify all primary AF hospitalizations (weighted national estimate = 425,690). These codes have previously been used to identify primary AF hospitalizations.13,14 A primary AF diagnosis refers to hospitalizations mainly attributable to AF, whereas a secondary diagnosis refers to hospitalizations in patients with AF who were admitted for reasons other than AF.
Impact of Arrhythmias on Hospitalizations in Patients With Cardiac Amyloidosis
2021, American Journal of CardiologyCitation Excerpt :Similarly, HF exacerbation can also aggravate AF, which leads to a vicious cycle. Patients with concurrent HF and AF have a worse prognosis and higher mortality irrespective of ejection fraction.8,23,24 There are several limitations of the study due to the inherent shortcomings of the NIS database.
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Authors contributed equally to manuscript.