Racial Differences in Length of Stay After Atrial Fibrillation Ablation

Area of Science:

• Cardiology
• Health Disparities Research
• Health Services Research

Background:

• Racial and sex disparities in catheter ablation (CA) for atrial fibrillation (AF) utilization are known.
• Less is understood about race and sex differences in comorbidity burden and quality of care post-CA.

Purpose of the Study:

• To characterize racial and sex differences in patient and procedural factors influencing prolonged length of stay (LOS) after CA for AF.
• To investigate the impact of race and sex on LOS following CA for AF.

Main Methods:

• Retrospective cohort study of 3345 patients undergoing CA for AF (2018-2024) from a single-center NCDR registry.
• Analysis focused on non-Hispanic White (NHW) and non-Hispanic Black (NHB) patients.
• Multivariable regression and causal mediation analysis assessed associations between race, sex, comorbidities, complications, and prolonged LOS.

Main Results:

• NHB patients were younger, had higher BMI, greater comorbidity burden, and more prolonged LOS and complications compared to NHW patients.
• Female patients were older, had higher rates of paroxysmal AF, transient ischemic attack, and chronic lung disease.
• NHB race (aOR 1.90) and procedural complications (aOR 156) were independently associated with prolonged LOS; sex was not.
• Race-related differences in prolonged LOS were partially mediated by comorbidity burden and obesity, not complications.

Conclusions:

• Prolonged LOS is more common in NHB patients undergoing CA for AF.
• Higher comorbidity burden and obesity, not complications, partially explain the increased LOS in NHB patients.
• Addressing comorbidity management and sociocultural disparities is crucial to reduce prolonged hospitalizations after CA for AF.