Trends and predictors of readmission after catheter ablation for atrial fibrillation, 2009-2013

• Published in: The American heart journal 2015-09, Vol.170 (3), p.483-489
• Main Authors: Noseworthy, Peter A., MD, Kapa, Suraj, MD, Haas, Lindsey R., MPH, Van Houten, Holly, BA, Deshmuk, Abhishek J., MD, Mulpuru, Siva K., MD, McLeod, Christopher J., MD, Asirvatham, Samuel J., MD, Friedman, Paul A., MD, Shah, Nilay D., PhD, Packer, Douglas L., MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Atrial Fibrillation - physiopathology; Atrial Fibrillation - surgery; Cardiac arrhythmia; Cardiovascular; Catheter Ablation - adverse effects; Catheters; Female; Follow-Up Studies; Hospitalization; Humans; Male; Medicare; Middle Aged; Patient Readmission - trends; Recurrence; Reoperation - statistics & numerical data; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2015.05.018

Background As the number of patients undergoing catheter ablation for atrial fibrillation (AF) increases, there is a growing focus on optimizing the quality and efficiency of. Readmission is often considered an indicator of both quality and efficiency of care delivery. We sought to estimate rates and identify predictors of readmission after catheter ablation. Methods and Results Using a large, national administrative claims database, we identified all AF patients who underwent catheter ablation between January 2009 and December 2013 (10,705 ablation cases). We examined incident readmission and the primary diagnosis during the readmission episode of care. We used Cox proportional hazard models to identify associations between readmission and patient and institutional characteristics. A total of 1,433 (13.4%) ablation patients were readmitted within 90 days of ablation for any cause, and 573 (5.4%) were admitted with AF as the primary diagnosis. There was a decline in all-cause (from 15.6% to 12.8%; P = .04) and AF-related (6.4%-5.0 %; P = .03) 90-day readmission over the study period. In a multivariate model, earlier year of ablation and each of 9 chronic conditions (alone or in combination) were independently associated with risk of readmission. Conclusions Between 2009 and 2013, there was a reduction in 90-day readmission rates after AF ablation, suggesting improved periprocedural care of these patients. Identifying patients at high risk for readmission after catheter ablation for AF may offer an opportunity for early intervention and, ultimately, reduction in procedural morbidity and medical costs.