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Association of Atrial Ablation Procedure and Palliative Care for High-Risk Mortality Group With Atrial Fibrillation

Fye Angelyn Pinera1,2, Pearl Angela Pinera1,2, Pearl Kim2

  • 1Center for Academic Enrichment and Outreach, University of Nevada, Las Vegas, NV, USA.

Journal of Palliative Care
|September 9, 2025
PubMed

Insights

Palliative care and atrial ablation are often used separately in high-risk atrial fibrillation patients. This study found they are inversely associated, highlighting potential disparities and a need for integrated care.

Area of Science:

  • Cardiology and Palliative Care Medicine
  • Health Services Research
  • Health Disparities Research

Background:

  • Atrial fibrillation (AF) is a growing cause of cardiovascular mortality in the U.S.
  • Palliative care (PC) and atrial ablation (AA) can improve quality of life for high-risk AF patients with comorbidities.
  • The combined management of PC and AA in high-risk AF populations requires further investigation.

Purpose of the Study:

  • To explore the utilization and association of palliative care (PC) and atrial ablation (AA) in high-risk mortality groups with atrial fibrillation (AF).
  • To identify factors associated with PC and AA utilization, including patient demographics and clinical characteristics.
  • To examine potential health disparities in the delivery of PC and AA for AF patients.

Main Methods:

  • Utilized pooled, cross-sectional, retrospective data from the National Inpatient Sample (2016-2021).
  • Included 2,965,334 hospital discharges for high-risk mortality AF patients.
  • Performed multivariable regression analysis, controlling for race/ethnicity, insurance, and hospital location, focusing on CHA2DS2-VASc score, systolic heart failure, and in-hospital mortality.

Main Results:

  • Palliative care utilization increased from 9.02% in 2016 to 12.29% in 2021.
  • PC utilization was negatively associated with higher CHA2DS2-VASc scores, systolic heart failure, and AA procedures. Racial minorities and rural residents showed lower PC utilization.
  • Atrial ablation was positively associated with systolic heart failure but negatively associated with higher CHA2DS2-VASc scores and PC utilization. Racial minorities and rural residents were less likely to receive AA.

Conclusions:

  • Palliative care utilization was strongly inversely associated with AA procedures (approx. 75% lower probability), suggesting discrete utilization patterns.
  • Identified significant health disparities in both PC and AA utilization among racial minorities and rural residents.
  • A call to action is needed to increase PC awareness and promote a harmonious, integrated approach to PC and AA for high-risk AF patients.

Keywords:
ablation procedureatrial fibrillationhospitalpalliative care

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