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Findings From NCDR AFib Ablation Registry
Quick Takes
- Among >76,000 patients undergoing catheter ablation for AF during the first 5 years of the NCDR AFib Ablation Registry, successful isolation of all pulmonary veins was achieved in 92.4% of cases.
- Furthermore, the procedure appears safe with the incidence of all complications at 2.5%, major complications at 0.9%, and death at 0.05%.
- Data from this registry may be useful for quality improvement initiatives and to generate real-world evidence-based guideline recommendations.
Study Questions:
What are the patient, hospital, and physician characteristics and in-hospital outcomes related to atrial fibrillation (AF) ablation in the first 5 years of the National Cardiovascular Data Registry (NCDR) AFib Ablation Registry?
Methods:
The authors describe the AFib Ablation Registry structure and governance, outcome assessment processes, data quality, and data collection processes. The characteristics of the patient population, hospitals, and in-hospital outcomes are also described. Patient and hospital characteristics are reported as mean ± standard deviation and median (interquartile range).
Results:
A total of 76,219 patients were included in the registry between January 2016 and December 2020 (mean age 65.5 ± 10.3 years, 65.2% male, 55.8% paroxysmal AF, mean CHA2DS2-VASc score 2.7 ± 1.6) treated by 708 physicians in 162 hospitals. Successful isolation of all pulmonary veins was achieved in 92.4% of patients. The prevalence of any complication during procedural admission was 2.50% and major complication was 0.9%, including significant bradycardia in 0.47%, heart failure in 0.47%, and pericardial effusion requiring intervention in 0.44%. Hospitalization >1 day occurred in 11.8% of patients, and in-hospital death was rare (n = 41 [0.05%]).
Conclusions:
The authors report that results in the first 5 years showed that successful pulmonary vein isolation is achieved in the majority of patients with AF, with a low rate of complications.
Perspective:
This analysis reports that among >76,000 patients undergoing catheter ablation for AF during the first 5 years of the NCDR AFib Ablation Registry, successful isolation of all pulmonary veins was achieved in 92.4% of cases. Furthermore, the procedure appears safe with the incidence of all complications at 2.5%, major complications at 0.9%, and death at 0.05%. Data from this registry may be useful for quality improvement initiatives and to generate real-world evidence-based guideline recommendations.
Clinical Topics: Arrhythmias and Clinical EP, Heart Failure and Cardiomyopathies, Pericardial Disease, Prevention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure
Keywords: Arrhythmias, Cardiac, Atrial Fibrillation, Bradycardia, Catheter Ablation, Heart Failure, Hospital Mortality, National Cardiovascular Data Registries, Outcome Assessment, Health Care, Pericardial Effusion, Pulmonary Veins, Quality Improvement, Secondary Prevention
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