Impact of frailty in hospitalized patients undergoing catheter ablation for atrial fibrillation.
Publication/Presentation Date
10-1-2024
Abstract
BACKGROUND: Catheter Ablation (CA) is an effective treatment for atrial fibrillation (AF). However, frail elderly patients have been understudied due to their exclusion from landmark trials.
OBJECTIVES: Our study aims to evaluate outcomes in this population.
METHODS: The national readmission database (2016-2020) was queried, and frailty categories were defined based on hospital risk frailty scores ≦5 as low while >5 as intermediate/high frailty (IHF). We used multivariate regression and propensity-matched analysis to compare outcomes in patients undergoing CA for atrial fibrillation based on frailty index.
RESULTS: Among 55 936 CAs for AF, 33,248 patients had low frailty, while 22 688 had intermediate/high frailty (IHF). After propensity matching (N 12 448), IHF patients were found to have higher adverse events, including mortality (3% vs. 0.3%, p < .001), stroke (1.9% vs. 0.2%, p < .001), acute heart failure (53.8% vs. 42.2%, p < .001), AKI (42.5% vs. 6.8%, p < .001), pericardial complications (2.8 vs. 1.6%, p < .001), respiratory complications (27.8 vs. 7.2%, p < .001), major adverse cardiovascular events (21.2 vs. 9.4%, p < .001) and net adverse events (76.7 vs. 55%, p < .001). IHF patients had higher readmissions at 30 (15.5 vs. 12.6%, p < .001), 90 (31.9 vs. 25.1%, p < .001), and 180-day (41 vs. 34.7%, p < .001) intervals. A higher median length of stay (LOS) (7 vs. 3 days, p < .001) and cost ($44 287 vs. $27 517, p < .001) at index admission and subsequent readmissions were also observed (p < .001).
CONCLUSION: Intermediate/high frailty patients undergoing catheter ablation had worse clinical outcomes, higher healthcare burden, and readmission rates. LOS has decreased in both groups from 2016 to 2020; however, total cost has increased.
Volume
35
Issue
10
First Page
1929
Last Page
1938
ISSN
1540-8167
Published In/Presented At
Ali, S., Kumar, M., Khlidj, Y., Hendricks, E., Farooq, F., Alruwaili, W., Keisham, B., Duhan, S., Gonuguntla, K., Sattar, Y., Shaik, A., Brar, V., Asad, Z. U. A., Sorajja, D., Dominic, P., & Helmy, T. (2024). Impact of frailty in hospitalized patients undergoing catheter ablation for atrial fibrillation. Journal of cardiovascular electrophysiology, 35(10), 1929–1938. https://doi.org/10.1111/jce.16383
Disciplines
Medicine and Health Sciences
PubMedID
39075813
Department(s)
Fellows and Residents
Document Type
Article