Safety of Catheter Ablation Therapy for Atrial Fibrillation in Cardiac Amyloidosis
Background Despite the high burden of atrial fibrillation in cardiac amyloidosis (CA), the safety of catheter ablation therapy in CA is not well established. We sought to examine short‐term safety outcomes following atrial fibrillation ablation in patients with CA compared with matched patients with...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.029339 |
| _version_ | 1797742624073842688 |
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| author | Hassan A. Alhassan Aleesha Kainat Joseph Donohue Scott J. Baumgartner Harriet Akunor Samir Saba Sandeep Jain Prem Soman |
| author_facet | Hassan A. Alhassan Aleesha Kainat Joseph Donohue Scott J. Baumgartner Harriet Akunor Samir Saba Sandeep Jain Prem Soman |
| author_sort | Hassan A. Alhassan |
| collection | DOAJ |
| description | Background Despite the high burden of atrial fibrillation in cardiac amyloidosis (CA), the safety of catheter ablation therapy in CA is not well established. We sought to examine short‐term safety outcomes following atrial fibrillation ablation in patients with CA compared with matched patients with dilated cardiomyopathy (DCM). Methods and Results Using data from the National Inpatient Sample, we identified all hospitalizations for atrial fibrillation ablation from the fourth quarter of 2015 through 2019. Admissions for CA and DCM were matched in a 1:5 ratio using propensity scores based on the following sociodemographics: age, sex, race or ethnicity, payor, median income, comorbidities, and hospital characteristics. We compared in‐hospital outcomes between both cardiomyopathies. We identified 1395 unweighted hospitalizations (representing 6750 national hospitalizations) for atrial fibrillation ablation, out of which 45 (3.2%) were admissions for CA. Compared with DCM, patients with CA were older (72.9 versus 65.1 years), had a higher burden of prior stroke (20.0% versus 8.6%) and chronic kidney disease (53.3% versus 33.6%), and were less likely to have a prior implantable cardioverter‐defibrillator (4.4% versus 23.0%). We successfully matched 42 CAs to 210 DCM hospitalizations. After matching, there was no difference in total complications (14.3% versus 10.5%, P=0.60), length‐of‐stay (3.1 versus 2.1 days, P=0.23), home disposition (97.6% versus 96.2%, P=0.65), and total charges ($137 250 versus $133 910, P=0.24). Conclusions In this nationally representative study of atrial fibrillation catheter ablation in CA, short‐term safety outcomes and complication rates were similar to a propensity score‐matched cohort of DCM. Further studies exploring long‐term safety outcomes are needed. |
| first_indexed | 2024-03-12T14:43:16Z |
| format | Article |
| id | doaj.art-af72b3b9470740f6a850bbfdce19d193 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-12T14:43:16Z |
| publishDate | 2023-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-af72b3b9470740f6a850bbfdce19d1932023-08-16T04:54:43ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-07-01121410.1161/JAHA.122.029339Safety of Catheter Ablation Therapy for Atrial Fibrillation in Cardiac AmyloidosisHassan A. Alhassan0Aleesha Kainat1Joseph Donohue2Scott J. Baumgartner3Harriet Akunor4Samir Saba5Sandeep Jain6Prem Soman7Department of Medicine University of Pittsburgh Medical Center Pittsburgh PA USADepartment of Medicine University of Pittsburgh Medical Center McKeesport PA USADepartment of Medicine University of Pittsburgh Medical Center Pittsburgh PA USADepartment of Medicine University of Pittsburgh Medical Center Pittsburgh PA USADepartment of Medicine Albert Einstein College of Medicine/Jacobi Medical Center Bronx NY USAHeart and Vascular Institute University of Pittsburgh Medical Center Pittsburgh PA USAHeart and Vascular Institute University of Pittsburgh Medical Center Pittsburgh PA USAHeart and Vascular Institute University of Pittsburgh Medical Center Pittsburgh PA USABackground Despite the high burden of atrial fibrillation in cardiac amyloidosis (CA), the safety of catheter ablation therapy in CA is not well established. We sought to examine short‐term safety outcomes following atrial fibrillation ablation in patients with CA compared with matched patients with dilated cardiomyopathy (DCM). Methods and Results Using data from the National Inpatient Sample, we identified all hospitalizations for atrial fibrillation ablation from the fourth quarter of 2015 through 2019. Admissions for CA and DCM were matched in a 1:5 ratio using propensity scores based on the following sociodemographics: age, sex, race or ethnicity, payor, median income, comorbidities, and hospital characteristics. We compared in‐hospital outcomes between both cardiomyopathies. We identified 1395 unweighted hospitalizations (representing 6750 national hospitalizations) for atrial fibrillation ablation, out of which 45 (3.2%) were admissions for CA. Compared with DCM, patients with CA were older (72.9 versus 65.1 years), had a higher burden of prior stroke (20.0% versus 8.6%) and chronic kidney disease (53.3% versus 33.6%), and were less likely to have a prior implantable cardioverter‐defibrillator (4.4% versus 23.0%). We successfully matched 42 CAs to 210 DCM hospitalizations. After matching, there was no difference in total complications (14.3% versus 10.5%, P=0.60), length‐of‐stay (3.1 versus 2.1 days, P=0.23), home disposition (97.6% versus 96.2%, P=0.65), and total charges ($137 250 versus $133 910, P=0.24). Conclusions In this nationally representative study of atrial fibrillation catheter ablation in CA, short‐term safety outcomes and complication rates were similar to a propensity score‐matched cohort of DCM. Further studies exploring long‐term safety outcomes are needed.https://www.ahajournals.org/doi/10.1161/JAHA.122.029339atrial fibrillationcardiac amyloidosiscatheter ablationcomplicationsdilated cardiomyopathysafety |
| spellingShingle | Hassan A. Alhassan Aleesha Kainat Joseph Donohue Scott J. Baumgartner Harriet Akunor Samir Saba Sandeep Jain Prem Soman Safety of Catheter Ablation Therapy for Atrial Fibrillation in Cardiac Amyloidosis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atrial fibrillation cardiac amyloidosis catheter ablation complications dilated cardiomyopathy safety |
| title | Safety of Catheter Ablation Therapy for Atrial Fibrillation in Cardiac Amyloidosis |
| title_full | Safety of Catheter Ablation Therapy for Atrial Fibrillation in Cardiac Amyloidosis |
| title_fullStr | Safety of Catheter Ablation Therapy for Atrial Fibrillation in Cardiac Amyloidosis |
| title_full_unstemmed | Safety of Catheter Ablation Therapy for Atrial Fibrillation in Cardiac Amyloidosis |
| title_short | Safety of Catheter Ablation Therapy for Atrial Fibrillation in Cardiac Amyloidosis |
| title_sort | safety of catheter ablation therapy for atrial fibrillation in cardiac amyloidosis |
| topic | atrial fibrillation cardiac amyloidosis catheter ablation complications dilated cardiomyopathy safety |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.029339 |
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