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

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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.

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Abbreviations

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

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Funding

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

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Author notes

  1. Jalaj Garg and Brijesh Patel contributed equally to this work.

Authors and Affiliations

  1. Division of Electrophysiology, Mount Sinai Medical Center, Icahn School of Medicine, New York, NY, USA

    Jalaj Garg

  2. Division of Cardiology, Lehigh Valley Health Network, Allentown, PA, USA

    Brijesh Patel & Mahek Shah

  3. Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD, USA

    Rahul Chaudhary

  4. Department of Medicine, Westchester Medical Center, Valhalla, NY, USA

    Rahul Gupta

  5. Department of Cardiology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA

    Sampath Gunda, Santosh K. Padala & Kenneth A. Ellenbogen

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  1. Jalaj Garg
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Correspondence to Jalaj Garg.

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Garg, J., Patel, B., Chaudhary, R. et al. Predictors of 30-day readmissions after catheter ablation for atrial fibrillation in the USA. J Interv Card Electrophysiol 55, 243–250 (2019). https://doi.org/10.1007/s10840-018-0503-3

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  • DOI: https://doi.org/10.1007/s10840-018-0503-3

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