![]() ![]() The NIS is created and maintained by the Agency for Healthcare Research and Quality, for the Healthcare Cost and Utilization Project (HCUP). The study cohort was derived from the National Inpatient Sample (NIS). 2 METHODS 2.1 Data source and study population ![]() We have also expanded our research by dividing our patient population into paroxysmal and nonparoxysmal AF. 9 Therefore, we assessed short-term procedural outcomes comparing SA and CA in patients with HFrEF and AF. The evidence is indispensable as CA is performed more frequently among subjects with HFrEF. There is a lack of research comparing procedural outcomes of SA and CA among heart failure patients with reduced ejection fraction (HFrEF) or systolic heart failure and AF. Additionally, these trials also excluded patients with an ejection fraction below 45%. 6- 8 However, these clinical trials were bound by the limitations in terms of strict patient selection and limited patient population. 4, 5 Few randomized clinical trials published comparing SA vs CA have highlighted CA to have less consistent maintenance of sinus rhythm postprocedure. 3 Hence, CA is approved for drug-refractory AF by European and American guidelines. 2 However, recent advancements with the application of CA for the management of refractory AF have increased significantly owing to its low complexity and adverse events. Traditionally, the standard of care for drug-refractory AF was SA. 1 The varied treatment strategies of AF extend across a wide spectrum, including medical therapy (rate or rhythm control), catheter ablation (CA), and surgical ablation (SA). Further research with freedom from AF as one of the outcome is needed between two groups for HFrEF.Ītrial fibrillation (AF) is the most common cardiac rhythm dysfunction affecting ~5.3 million people across the United States. ConclusionĬA is associated with lower in-hospital adverse procedural outcomes as compared with SA among HFrEF hospitalizations with AF. In HFrEF hospitalizations with nonparoxysmal AF, SA as compared with CA was associated with a higher percentage of in-hospital mortality (2.4% vs 1%, adjusted P-value <.05), a longer length of stay, a higher cost of treatment, and a higher percentage of cardiac complications. Hospitalizations with SA had a significantly longer length of hospital stay, a higher percentage of postprocedural, and cardiac complications. The in-hospital mortality among HFrEF with AF undergoing SA as compared with CA was similar (2.8% vs 1.9%, respectively, adjusted P-value 0.09). Hospitalizations with CA had higher baseline comorbidities. ResultsĪ total of 1,770 HFrEF hospitalizations with AF who underwent SA and 1,620 HFrEF hospitalizations with AF who underwent CA were included in the analysis. Furthermore, the clinical outcomes of SA vs CA in AF stratified as nonparoxysmal and paroxysmal were analyzed. We used the national inpatient sample to identify hospitalizations over 18 years with HFrEF hospitalization and AF, and undergoing SA and CA from 2016 to 2017. The main objective was to compare the short-term procedural outcomes of SA and CA in patients with HFrEF. There is a lack of research comparing procedural outcomes of surgical ablation (SA) and catheter ablation (CA) among patients with heart failure with reduced ejection fraction (HFrEF) and atrial fibrillation (AF). ![]()
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