Predictors of 30-day readmissions after catheter ablation for atrial fibrillation in the USA

• Published in: Journal of interventional cardiac electrophysiology 2019-09, Vol.55 (3), p.243-250
• Main Authors: Garg, Jalaj, Patel, Brijesh, Chaudhary, Rahul, Shah, Mahek, Gupta, Rahul, Gunda, Sampath, Padala, Santosh K., Ellenbogen, Kenneth A.
• Format: Article
• Language: English
• Subjects: Ablation; Adolescent; Adult; Aged; Atrial Fibrillation - surgery; Cardiac arrhythmia; Cardiology; Catheter Ablation; Catheters; Complications; Congestive heart failure; Etiology; Female; Fibrillation; Health care; Heart; Hemorrhage; Humans; Lung diseases; Male; Medical instruments; Medicine; Medicine & Public Health; Middle Aged; Multimedia Report; Patient Readmission - statistics & numerical data; Patients; Postoperative Complications - epidemiology; Radiofrequency ablation; Renal failure; Retrospective Studies; Risk Factors; United States - epidemiology; Vascular diseases
• ISSN: 1383-875X; 1572-8595
• DOI: 10.1007/s10840-018-0503-3

Background Catheter ablation is considered as the mainstay treatment for patients with symptomatic atrial fibrillation (AF). We aimed to determine the predictors of 30-day readmission after catheter ablation for AF. Methods The study cohort consisted of patients who underwent AF catheter ablation (International Classification of Diseases, Ninth Revision 427.31 and procedure code 37.34) in 2014, identified from the National Readmission Database. Results Our final cohort consisted of 5322 unweighted cases, of which 4736 (89%) constituted the no-readmission group and 586 patients (11%) the readmission group. Female gender (OR 1.62, 95% CI 1.35–1.95), CAD (OR 1.36, 95% CI 1.08–1.71), peripheral vascular disease (OR 1.45, 95% CI 1.07–1.98), acute renal failure (OR 1.46, 95% CI 1.09–1.97), fluid and electrolyte disorders (OR 1.32, 95% CI 1.03–1.67), chronic pulmonary disease (OR 1.25, 95% CI 1.01–1.53), ablation on the day of admission (OR 0.74, 95% CI 0.61–0.91), and fourth quartile of hospital AF catheter ablation volume (OR 0.60, 95% CI 0.45–0.80) were independent predictors of 30-day readmission. Arrhythmias and heart failure were the most common cardiac etiologies for readmission. The most common ablation-related complications were hemorrhage (11%) and vascular (7%) complications. Conclusions Several patient- and hospital-related factors were identified as predictors of 30-day readmission, the knowledge of which can potentially improve healthcare delivery.