California Study of Ablation (CAABL): Early Utilization after Index Hospitalization for Non-Valvular Atrial Fibrillation

Uma N Srivatsa, Beate Danielsenb, Ezra Amsterdama, Yingbo Yanga, Dali Fan, Nayereh Pezeshkiana, Richard H. Whiteb

Research output: Contribution to journalArticle

Abstract

Background: Catheter ablation (ABL) for non-valvular AF (NVAF) is recommended for symptomatic patients refractory to medical therapy and its success is related to the duration of the arrhythmia prior to intervention.Our aim was to assess the early utilization and the factors that prompted ABL in patients hospitalized for new onset NVAF. Methods: Using de-identified administrative discharge records for hospitalizations and emergency department (ED) visits, we determined the patients who had a first-time (since 1991) health record diagnosis of AF between2005 - 2011. We linked ambulatory surgery encounters for ABL based on ICD 9 code occurring within two years of initial hospitalization. After excluding other cardiac arrhythmias, atrio-ventricular nodal ablation or pacemaker/defibrillator placement and cardiac valve disease, bivariate comparisons were made with those who did not undergo ABL. Results: During the study period,3,440 of 424,592 patients (0.81%) hospitalized for new onset NVAF underwent ABL. Parameters significantly (p<0.001) associated with ABL compared to non-ABL patients included: principal diagnosis of AF (55% vs 25%), age 35-64 yrs (46.1% vs. 22.4%), male (58.9% vs. 48.2%), private insurance (46.6% vs. 21.1%), Caucasian (81.0% vs.71.6%), lower frequency of ED visit < 6 months before index AF hospitalization (10.7% vs. 15.9%), lower severity of illness(SOI) at time of AF diagnosis (16.5% vs. 35.6%) anda lower prevalence of major comorbidities (p< 0.001). Conclusions: Ablation has low utilization for treatment of new onset NVAF within two years of diagnosis. Earlier utilization of ABL may reduce health care burden related to NVAF and requires further evaluation.

Original languageEnglish (US)
JournalJournal of Atrial Fibrillation
Volume10
Issue number1
StatePublished - Jun 1 2017

Keywords

  • Ablation
  • Atrial fibrillation
  • Epidemiology
  • Frequency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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