Procedural approaches for atrial fibrillation (AFib) ablation differ by hospital teaching status; however, overall complication rates are similar, according to a recent study published in JAHA.

Using data from ACC's AFib Ablation Registry, Sebastian E. Beyer, MD, MPH, et al., incorporated a total of 212,327 AFib ablation procedures (mean age 67 years, 35.5% female) from January 2016 to June 2024 into their analysis. Centers were classified as either university hospitals, nonuniversity teaching hospitals or nonteaching hospitals.

At university hospitals, authors noted the fewest number of cryoablations (unadjusted proportions: 14.4% vs. 29.9% at nonuniversity teaching hospitals and 16.9% at nonteaching hospitals, p<0.001), adjunctive lesions (59.0% vs. 63.3% vs. 66.9%, p<0.001), and empiric linear lesions (27.4% vs. 30.2% vs. 38.1%, p<0.001). Meanwhile, nonuniversity teaching hospitals performed the most single transseptal punctions and nonteaching hospitals performed the least (68.9% vs. 47.9%, p<0.001). After adjusting for patient characteristics and procedural volume, these differences persisted.

Other findings include a lower rate of same-day discharge at university hospitals (34.1% vs. 44.5% vs. 44.0%, p<0.001). No significant differences in overall complication rates or major complication rates were noted by hospital teaching status. Specifically, rates of mortality, myocardial infarction and thromboembolic events were similar among the three hospital groups.

According to the authors, these results demonstrate "that [AFib] catheter ablation, a lower-risk procedure, can be performed safely across all hospital types, regardless of teaching status. Further studies are needed to evaluate whether outcomes differ in high-risk subgroups, particularly in patients with severely reduced left ventricular ejection fraction or end-stage heart failure."