The majority of atrial fibrillation (AFib) ablation procedures result in successful pulmonary vein isolation with low complication rates, according to a study published Feb. 27 in JACC examining the first five years of data collected by the NCDR AFib Ablation Registry.

Jonathan Chong Hsu, MD, FACC, et al., analyzed a total of 76,219 patients (mean age 65.5±10.3 years, 65.2% male, 55.8% paroxysmal AFib, CHA₂DS₂-VASc score 2.7±1.6) captured by the ACC’s AFib Ablation Registry from January 2016 to December 2020. They found that successful isolation of all pulmonary veins was established in 92.4% of patients, while complication rates were low overall. The rate of any complication during procedural admission was 2.5%, while major complication was 0.9%. Major complications included significant bradycardia (0.47%), heart failure (0.47%) and pericardial effusion requiring intervention (0.44%).

Researchers additionally note that in-hospital death was rare (n=41, 0.05%), and hospitalization greater than one day occurred in 11.8% of patients. This first analysis of data from the AFib Ablation Registry mainly centered on taking stock of patient, hospital and physician characteristics, along with in-hospital AFib ablation outcomes.

Moving forward, the study authors emphasize the value of this dataset for future inquiry, including the ability to “assess practice trends, evaluate treatment patterns associated with different patient outcomes, and support development of evidence-based guidelines.”

In an accompanying editorial comment, Matthew R. Reynolds, MD, FACC, and Javaria Ahmad, MD, offer up the limitations of studies based on registry data while simultaneously recognizing the positives associated with the detail and scale of the AFib Ablation Registry.

“The AFib Ablation Registry has notable strengths, including a detailed data collection form that provides far richer clinical detail than insurance claims…the data are likely to be accurate, though some under-reporting of adverse events may still be possible,” they state. “Perhaps most importantly, the registry has the advantage of scale, by 2020 collecting more than 10 times more records than any previous prospective AFib ablation registry.”

Clinical Topics: Arrhythmias and Clinical EP, Pericardial Disease, Implantable Devices, Atrial Fibrillation/Supraventricular Arrhythmias

Keywords: Physicians, Registries, Hospitalization, Hospital Mortality, Pericardial Effusion, Bradycardia, Atrial Fibrillation, AFib Ablation Registry, National Cardiovascular Data Registries

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