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Multicenter Study
. 2023 Mar 7;81(9):867-878.
doi: 10.1016/j.jacc.2022.11.060.

Initial Findings From the National Cardiovascular Data Registry of Atrial Fibrillation Ablation Procedures

Jonathan C Hsu  1 , Douglas Darden  2 , Chengan Du  3 , Joseph E Marine  4 , Sheila Nichols  5 , Gregory M Marcus  6 , Andrea Natale  7 , Peter A Noseworthy  8 , Kimberly A Selzman  9 , Paul Varosy  10 , Frederick Masoudi  10 , James Freeman  3 , Jeptha Curtis  3 , Joseph Akar  3 , Peter R Kowey  11
Affiliations
Free article
Multicenter Study

Initial Findings From the National Cardiovascular Data Registry of Atrial Fibrillation Ablation Procedures

Jonathan C Hsu et al. J Am Coll Cardiol. .
Free article

Abstract

Background: The National Cardiovascular Data Registry (NCDR) AFib Ablation Registry was created to assess real-world prevalence, demographic characteristics, procedural management, and outcomes of patients undergoing atrial fibrillation (AF) ablation procedures.

Objectives: The goal of this study was to characterize the patient, hospital, and physician characteristics and in-hospital outcomes related to AF ablation in the first 5 years of the registry.

Methods: This paper describes the AFib Ablation Registry structure and governance, outcome assessment processes, data quality, and data collection processes. The characteristics of the patient population, hospitals, and in-hospital outcomes are also described.

Results: A total of 76,219 patients were included in the registry between January 2016 and December 2020 (mean age 65.5 ± 10.3 years, 65.2% male, 55.8% paroxysmal AF, mean CHA2DS2-VASc score 2.7 ± 1.6) treated by 708 physicians in 162 hospitals. Successful isolation of all pulmonary veins was achieved in 92.4% of patients. The prevalence of any complication during procedural admission was 2.50% and major complication was 0.9%, including significant bradycardia in 0.47%, heart failure in 0.47%, and pericardial effusion requiring intervention in 0.44%. Hospitalization >1 day occurred in 11.8% of patients, and in-hospital death was rare (n = 41 [0.05%]).

Conclusions: The NCDR AFib Ablation Registry is the largest multicenter, prospective cohort study of patients undergoing catheter ablation worldwide. Results in the first 5 years showed that successful pulmonary vein isolation is achieved in the majority of patients, with a low rate of complications. Future studies from the registry will assess practice trends, evaluate treatment patterns associated with different patient outcomes, and support development of evidence-based guidelines.

Keywords: National Cardiovascular Data Registry; atrial fibrillation; outcomes; percutaneous catheter ablation; prospective registry.

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Conflict of interest statement

Funding Support and Author Disclosures This study was funded by the NCDR. Dr Hsu has received honoraria from Medtronic, Abbott, Boston Scientific, Biotronik, Janssen Pharmaceuticals, Bristol Myers Squibb, Pfizer, Hill-Rom, iRhythm, Acutus Medical, Zoll Medical, and Biosense Webster; has equity interest in Vektor Medical; and has received research grants from Biotronik and Biosense Webster. Dr Freeman has received salary support from the ACC NCDR and the National Heart, Lung, and Blood Institute; has received consulting/advisory board fees (modest) from Boston Scientific, Medtronic, Janssen Pharmaceuticals, Biosense Webster, and PaceMate; and holds equity in PaceMate. Dr Curtis has an institutional contract with the ACC for his role as Senior Scientific Advisor of the NCDR; has received salary support from the ACC and the Centers for Medicaid & Medicare Services; and has equity in Medtronic. Dr Masoudi has previously served as Chief Scientific Advisor and Oversight Committee Chair of the NCDR. Dr Marine has received honoraria from the ACC for educational activities and service as a Trustee. Dr Natale is a consultant for Abbott, Baylis, Biosense Webster, Biotronik, Boston Scientific, and Medtronic. Dr Kowey has provided consultation to Medtronic, AtriCure, and a number of pharmaceutical companies that market antiarrhythmic and anticoagulant drugs, including Sanofi, Johnson & Johnson, Bristol Myers Squibb, Daiichi-Sankyo, and Boehringer Ingelheim. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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