ArticleJACC. Clinical electrophysiology2024
Outcomes of Atrial Fibrillation Ablation Among Older Adults in the United States: A Nationwide Study.
Article in JACC. Clinical electrophysiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Clinical Vulnerability Refines Rhythm-Related Outcomes in Older Patients Undergoing Pulmonary Vein Isolation for Atrial Fibrillation: An Observational Cohort Study.Journal of arrhythmia · 2026Article
- A network meta-analysis of comparative effectiveness and safety of pulsed field, radiofrequency, and cryoballoon ablation for atrial fibrillation.Heart rhythm O2 · 2026Article
- Patient Characteristics and Utilization Patterns of Ambulatory Atrial Fibrillation Ablation in the United States.JACC. Advances · 2026Article
- Effects of Sodium Glucose Co-Transporter 2 Inhibitors on Atrial Fibrillation Recurrences After Catheter Ablation in Atrial Fibrillation Patients: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Contemporary Administrative Codes to Identify Pulmonary Vein Isolation Procedures for Atrial Fibrillation.Journal of the American Heart Association · 2025Observational
- The Global Impact of Atrial Fibrillation.Arrhythmia & electrophysiology review · 2025Review
- Machine Learning-Based Identification of High-Risk Patterns in Atrial Fibrillation Ablation Outcomes.medRxiv : the preprint server for health sciences · 2024Article
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10 authors.
Funding
Abstract
backgroundPulmonary vein isolation (PVI) is increasingly recommended as first-line therapy for atrial fibrillation. Recent data suggest growing PVI volumes but rising complication rates, although comprehensive real-world outcomes including both inpatient and outpatient encounters remain unclear.
objectivesThe purpose of this study was to evaluate patient characteristics, population rates, and 30-day outcomes of PVI in a nationwide sample of U.S. adults aged >65 years.
methodsFirst-time PVIs were identified among U.S. Medicare fee-for-service beneficiaries using Current Procedural Terminology procedural codes. Comorbidities were ascertained using International Classification of Diseases-10th Revision diagnosis codes associated with each procedural claim. Outcomes included periprocedural complications, all-cause hospitalizations, and mortality at 30 days.
resultsFrom January 2017 through December 2021, a total of 227,133 patients underwent PVI (mean age 72.5 years, 42% women, 92.7% White) with an increasing comorbidity burden over time. PVI volume increased from 83.8 (2017) to 111.6 per 100,000 patient-years (2021), which was driven by outpatient procedures (87.8% of all PVIs). Concurrently, there was a significant decrease in complication rates (3.9% in 2017 vs 3.1% in 2021; P < 0.001) and hospitalizations (8.8% vs 7.0%; P < 0.001), with no significant change in mortality (0.4%; P = 0.08). The most common periprocedural complications were bleeding (1.8%), pericardial effusion (1.4%), and vascular access damage (0.8%).
conclusionsThe use of PVI has steadily increased among older patients in contemporary U.S. clinical practice; yet, cumulative complication and hospitalization rates at 30 days have decreased over time, with stably low rates of short-term mortality despite rising comorbidity burden among treated patients. These data may reassure patients and providers on the safety of PVI as an increasingly common first-line procedure for atrial fibrillation.
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