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Updated: Jun 28, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Atrial Fibrillation Ablation Outcomes by Hospital Academic Status
Muhammad Raffey Shabbir1, Khubaib Ahmad1, Mahrukh Imtiaz2
1Marshfield Clinic, Sanford Health, Marshfield, Wisconsin, USA.
Insights
Catheter ablation for atrial fibrillation (AF) at academic hospitals shows better outcomes than at non-academic centers. Patients treated at non-academic sites had higher risks of repeat procedures and acute kidney injury.
Area of Science:
- Cardiology
- Medical Outcomes Research
Background:
- Atrial fibrillation (AF) is a prevalent global arrhythmia.
- Catheter ablation is an effective AF treatment, but outcomes vary by institution.
- This study compares AF ablation outcomes between academic and non-academic hospitals.
Purpose of the Study:
- To compare the effectiveness and safety of atrial fibrillation catheter ablation performed at academic versus non-academic medical centers.
- To identify potential disparities in patient outcomes based on hospital type.
Main Methods:
- Retrospective cohort study using the TriNetX US Collaborative Network (2010-2020).
- Included adults (35-90 years) undergoing AF ablation, excluding specific cardiac conditions.
- 1:1 propensity score matching balanced groups by hospital academic status.
- Outcomes assessed within 365 days post-ablation; statistical significance set at p < 0.05.
Main Results:
- Patients at non-academic institutions had higher odds of requiring repeat ablation (OR: 1.844) and developing acute kidney injury (OR: 1.534).
- No significant differences were observed in cardiac arrest, tamponade, esophageal perforation, or hemorrhage rates.
- These findings suggest a disparity in AF ablation outcomes based on institutional setting.
Conclusions:
- Academic hospital settings are associated with superior outcomes for atrial fibrillation catheter ablation.
- Potential factors include advanced expertise, post-operative care, and institutional resources.
- Standardization of care and improved access to high-standard care are crucial for reducing outcome disparities.
Background:
Atrial fibrillation (AF) is the most prevalent arrhythmia worldwide, and catheter ablation has been established as an effective treatment modality. The outcomes can vary based on medical expertise and the location of the procedure. This study evaluates the differences in outcomes of catheter ablation performed at non-academic compared to academic institutions.
Aims:
To compare the outcomes of atrial fibrillation procedures executed in non-academic versus academic centers.
Methods:
A retrospective cohort study was conducted using the TriNetX US Collaborative Network. Adults (35-90 years) who underwent AF ablation between January 1, 2010, and January 1, 2020, were included. Those with congenital malformations of circulatory system, rheumatic heart disease, ischemic cardiomyopathy, or prior myocardial infarction (MI) were excluded. Groups were stratified by hospital academic status and balanced using 1:1 propensity score matching. Outcomes were assessed within 365 days post-ablation. Patients with outcome prior to the time window were excluded, and the odds ratio was used for statistical comparisons with significance set at p < 0.05.
Results:
Following propensity score matching, the analysis revealed that patients undergoing AF ablation at non-academic institutions had significantly higher odds of requiring additional or redo ablation (OR: 1.844; 95% CI: 1.409-2.415) and developing acute kidney injury (OR: 1.534; 95% CI: 1.054-2.232) compared to those treated at academic institutions. Other post-ablation complications, including cardiac arrest (OR: 1.101; 95% CI: 0.466-2.599), cardiac tamponade (OR: 1.101; 95% CI: 0.466-2.599), esophageal perforation (OR: 1.000; 95% CI: 0.415-2.409), and hemorrhages or hematomas (OR: 0.909; 95% CI: 0.385-2.145), did not differ significantly between the two groups.
Conclusion:
Catheter ablation of AF performed at academic hospitals resulted in better outcomes, potentially reflecting advanced technical expertise, post-op care, and better institutional resources. These results highlight the importance of standardization of care and the need for increased access of high-standard care across healthcare settings. Future studies should investigate modifiable institutional factors and patient-level variables driving this disparity.
