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. 2018 Jun 30;11(1):2036.
doi: 10.4022/jafib.2036. eCollection 2018 Jun-Jul.

California Study of Ablation for Atrial Fibrillation:Re-hospitalization for Cardiac Events (CAABL-CE)

Uma N Srivatsa  1 , Guibo Xing  2 , Ezra Amsterdam  1 , Nipavan Chiamvimonvat  1 , Nayereh Pezeshkian  1 , Dali Fan  1 , Richard H White  3
Affiliations

California Study of Ablation for Atrial Fibrillation:Re-hospitalization for Cardiac Events (CAABL-CE)

Uma N Srivatsa et al. J Atr Fibrillation. .

Abstract

Background: Catheter ablation (ABL) for non-valvular (NV) atrial fibrillation (AF) improves rhythm control. Our aim was to compare re-hospitalization for heart failure (HF), acute coronary syndrome (ACS), or recurrent AF among patients with NVAF who underwent ABL versus controls.

Methods: From the Office of Statewide Planning and Development (OSHPD) database, we identified all patients who had at least one hospitalization for AF between 2005-2013. Patients who subsequently underwent ABL were compared to controls (up to fivematched controls by age, sex and duration of AF between diagnosis and time of ABL). Cases with valve disease, open maze, other arrhythmias, or implanted cardiac devices were excluded. Pre-specified clinical outcomes including readmission for HF, ACS, severe or simple AF (severe = with HF or ACS; simple= without HF or ACS)were assessed using a weighted proportional hazard model adjusting for number of hospital admissions with AF before the ABL, calendar year of ABL, and presence of chronic comorbidities.

Results: The study population constituted 8338 cases and controls, with mean 3.5+ 1 patient-year follow up. In the ABL cohort, there was lower risk of re-hospitalizations for HF, HR=0.55(95%CI: 0.43-0.69,); ACS,HR=0.5(95%CI: 0.35-0.72,); severe AF [HR=0.86 (CI:0.74-0.99), and higher for simple AF, HR=1.25 (CI:1.18-1.33).

Conclusions: In patients with NVAF,although ABL is associated with increased risk of re-hospitalization for simple AF, ABL was associated with a significant reduction in the risk of re-hospitalization for HF, ACS and severe AF. These findingsrequireconfirmation in a prospective clinical trial.

Keywords: Acute Coronary Syndrome; Atrial fibrillation Ablation; Heart Failure.

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Figures

Figure 1.
Figure 1.. Study design
Figure 2A.
Figure 2A.. 2 Probability of not experiencing outcomes (Y axis), Days of follow up (X axis) A- Congestive heart failure
Figure 2B.
Figure 2B.. Probability of not experiencing outcomes (Y axis), Days of follow up (X axis); B-Acute coronary syndrome
Figure 2C.
Figure 2C.. Probability of not experiencing outcomes (Y axis), Days of follow up (X axis)C- Simple Atrial fibrillation
Figure 2D.
Figure 2D.. Probability of not experiencing outcomes (Y axis), Days of follow up (X axis)D-Severe Atrial fibrillation.
See this image and copyright information in PMC

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