Rising Comorbidity Burden in Inpatient Atrial Fibrillation Catheter Ablation: Temporal Trends and In-Hospital...

Area of Science:

• Cardiology
• Health Services Research

Background:

• Catheter ablation (CA) for atrial fibrillation (AF) has seen technical advancements, yet success rates remain stagnant.
• Treating elderly patients with multiple comorbidities may reduce CA efficacy and increase complication risks.

Purpose of the Study:

• To analyze trends in comorbidity burden among patients undergoing inpatient CA for AF.
• To assess the association between comorbidity burden and in-hospital outcomes.

Main Methods:

• Analysis of 64,995 inpatient CA procedures for AF from the National Inpatient Sample (2016-2021).
• Comorbidity burden evaluated using a standardized index; outcomes compared between high and low burden groups.
• Annual trends in high comorbidity burden patient rates calculated.

Main Results:

• The proportion of AF CA patients with high comorbidity burden rose from 11.7% (2016) to 22.1% (2021).
• High comorbidity burden patients experienced higher total complications (14.2% vs. 7.8%) and in-hospital mortality (1.5% vs. 0.2%).
• Complications were driven by vascular, infectious, and respiratory issues, not cardiac ones.

Conclusions:

• Inpatient AF CA is increasingly performed in patients with significant comorbidities.
• Preprocedural risk-benefit assessment is crucial for optimizing outcomes in high-comorbidity patients.