Contemporary trends and in-hospital outcomes of catheter and stand-alone surgical ablation of atrial fibrillation

Robert W. Ariss, Abdul Mannan Khan Minhas, Neha J. Patel, Fnu Zafrullah, Krupa Bhavsar, Salik Nazir, Hani Jneid, George V. Moukarbel

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Aims: The contemporary trends in catheter ablation (CA) and surgical ablation (SA) utilization and surgical techniques [open vs. thoracoscopic, with or without left atrial appendage closure (LAAC)] are unclear. In addition, the in-hospital outcomes of stand-alone SA compared with CA are not well-described. Methods and results: The National Inpatient Sample 2010-18 was queried for atrial fibrillation (AF) hospitalizations with CA or stand-alone SA. Complex samples multivariable logistic and linear regression models were used to compare the association between stand-alone SA vs. CA and the primary outcomes of in-hospital mortality and stroke. Of 180 243 hospitalizations included within the study, 167 242 were for CA and 13 000 were for stand-alone SA. Catheter ablation and stand-alone SA hospitalizations decreased throughout the study period (Ptrend < 0.001). Surgical ablation had higher rates of in-hospital mortality [adjusted odds ratio (aOR) 2.26; 95% confidence interval (CI) 1.41-3.61; P = 0.001] and stroke (aOR 4.64; 95% CI 3.25-6.64; P < 0.001) compared with CA. When examining different surgical approaches, thoracoscopic SA was associated with similar in-hospital mortality (aOR 1.53; 95% CI 0.60-3.89; P = 0.369) and similar risk of stroke (aOR 1.75; 95% CI 1.00-3.07; P = 0.051) compared with CA. Conclusion: Stand-alone SA comprises a minority of AF ablation procedures and is associated with increased risk of mortality, stroke, and other in-hospital complications compared to CA. However, when a thoracoscopic approach was utilized, the risks of mortality and stroke appear to be reduced.

Original languageEnglish (US)
Pages (from-to)218-225
Number of pages8
JournalEuropace
Volume24
Issue number2
DOIs
StatePublished - Feb 1 2022
Externally publishedYes

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • In-hospital outcome
  • Mortality
  • Stand-alone surgical ablation
  • Trends

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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