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

  • Jalaj GargEmail author
  • Brijesh Patel
  • Rahul Chaudhary
  • Mahek Shah
  • Rahul Gupta
  • Sampath Gunda
  • Santosh K. Padala
  • Kenneth A. Ellenbogen
MULTIMEDIA REPORT
  • 45 Downloads

Abstract

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.

Keywords

Catheter ablation Atrial fibrillation Readmission National Readmission Database 

Abbreviation

AF

Atrial fibrillation

NIS

National Inpatient Sample

NRD

National Readmission Database

ICD-9-CM

International Classification of Diseases, Ninth Revision, Clinical Modification

LOS

Length of stay

IQR

Interquartile range

CAD

Coronary artery disease

PVD

Peripheral vascular disease

ARF

Acute renal failure

SND

Sinus node dysfunction

TIA

Transient ischemic attack

Notes

Funding

The cost of software and database was funded by Dorothy Rider Pool Trust Fund (Grant: 1573-007), Lehigh Valley Health Network.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Not applicable

Ethical approval

Not applicable

Supplementary material

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Electrophysiology, Mount Sinai Medical CenterIcahn School of MedicineNew YorkUSA
  2. 2.Division of CardiologyLehigh Valley Health NetworkAllentownUSA
  3. 3.Department of MedicineSinai Hospital of BaltimoreBaltimoreUSA
  4. 4.Department of MedicineWestchester Medical CenterValhallaUSA
  5. 5.Department of CardiologyVirginia Commonwealth University School of MedicineRichmondUSA

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