ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2025
Outcomes of atrial fibrillation ablation in community hospitals with and without onsite cardiothoracic surgery availability.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLimited data exist on outcomes of atrial fibrillation (AF) catheter ablation based on hospital setting and, specifically, the availability of onsite cardiothoracic surgery (CTS). We aimed to describe the characteristics and outcomes of catheter ablation for AF performed at a facility with and without CTS.
methodsThis was a retrospective study of consecutive patients who underwent catheter ablation for AF at hospital with (CTS) and without cardiothoracic surgery (N-CTS) from January 2011 through December 2019. Clinical and procedural characteristics, complications, and 1-year outcomes, including clinical events and AF recurrence, were collected.
resultsThere were 326 unique patients who underwent an index AF ablation procedure: 206 CTS patients and 120 N-CTS patients. There were no differences in overall cardiac complications (2.5% vs. 5.8%), including mapping catheter entrapment requiring open-heart surgery (0% vs. 0.5%), pericardial effusion requiring pericardiocentesis (0.8% vs. 0.5%), hemopericardium (1.7% vs. 0.5%), acute myocardial infarction (0% vs. 1.0%), and sinus node injury (0% versus 0.5%) (all P values > .05) between N-CTS and CTS patients. Likewise, overall noncardiac complications (20.7% vs. 19.8%, P = .85), including bleeding, cerebrovascular accident, and phrenic or vagus nerve injury, were similar between N-CTS and CTS hospitals. Also, 1-year cumulative Kaplan-Meier estimates of overall AF recurrence (11.6% vs. 16.4%; log-rank P = 0.21; HR 1.47; 95% CI, 0.79-2.74) were not statistically significant between N-CTS and CTS hospitals.
conclusionCatheter ablation procedure is safe and effective regardless of onsite CTS presence, and there were no significant differences between the two hospital settings.
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