Short-term outcomes of atrial flutter ablation

Authors

• Byomesh Tripathi, Mount Sinai St Luke's, Roosevelt Hospital, New York, NY, USA.
• Shilpkumar Arora, Mount Sinai St Luke's, Roosevelt Hospital, New York, NY, USA.
• Abhishek Mishra, Guthrie Robert Packer Hospital, PA, USA.
• Vishwa Reddy Kundoor, Guthrie Robert Packer Hospital, PA, USA.
• Sopan Lahewala, RWJ Barnabas Health/Jersey City Medical Center, Jersey City, NJ, USA.
• Varun Kumar, Mount Sinai St Luke's, Roosevelt Hospital, New York, NY, USA.
• Mahek Shah, Lehigh Valley Hospital, Allentown, PA, USA.
• Dhairya Lakhani, Mount Sinai St Luke's, Roosevelt Hospital, New York, NY, USA.
• Harshil Shah, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
• Nilay V. Patel, St. Peter's University Hospital, New Brunswick, NJ, USA.
• Nileshkumar J. Patel, University of Miami/Miller School of Medicine, Miami, FL, USA.
• Mihir Dave, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
• Abhishek Deshmukh, Mayo Clinic, Rochester, MN, USA.
• Sattur Sudhakar, Guthrie Robert Packer Hospital, PA, USA.
• Radha Gopalan, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Document Type

Article

Abstract

BACKGROUND: Understanding the factors associated with early readmissions following atrial flutter (AFL) ablation is critical to reduce the cost and improving the quality of life in AFL patients. METHOD: The study cohort was derived from the national readmission database 2013-2014. International Classification of Diseases, 9th Revision (ICD-9-CM) diagnosis code 427.32 and procedure code 37.34 were used to identify AFL and catheter ablation, respectively. The primary and secondary outcomes were 90-day readmission and complications including in-hospital mortality. Cox proportional regression and hierarchical logistic regression were used to generate the predictors of primary and secondary outcomes respectively. Readmission causes were identified by ICD-9-CM code in primary diagnosis field of readmissions. RESULT: Readmission rate of 18.19% (n = 1,010 with 1,396 readmissions) was noted among AFL patients (n = 5552). Common etiologies for readmission were heart failure (12.23%), atrial fibrillation (11.13%), atrial flutter (8.93%), respiratory complications (9.42%), infections (7.4%), bleeding (7.39%, including GI bleed-4.09% and intracranial bleed-0.79%) and stroke/TIA (1.89%). Multivariate predictors of 90-day readmission (hazard ratio, 95% confidence interval, P value) were preexisting heart failure (1.30, 1.13-1.49, P < 0.001), chronic pulmonary disease (1.37, 1.18-1.58, P < 0.001), anemia (1.23, 1.02-1.49, P = 0.035), malignancy (1.87, 1.40-2.49, P < 0.001), weekend admission compared to weekday admission (1.23, 1.02-1.47, P = 0.029), and length of stay (LOS) ≥5 days (1.39, 1.16-1.65, P < 0.001). Note that 50% of readmissions happened within 30 days of discharge. CONCLUSION: Cardiac etiologies remain the most common reason for the readmission after AFL ablation. Identifying high risk patients, careful discharge planning, and close follow-up postdischarge can potentially reduce readmission rates in AFL ablation patients.

Medical Subject Headings

Adolescent; Adult; Aged; Aged, 80 and over; Atrial Flutter (diagnostic imaging, physiopathology, surgery); Catheter Ablation (trends); Cohort Studies; Databases, Factual (trends); Female; Humans; Male; Middle Aged; Patient Readmission (trends); Time Factors; Treatment Outcome; Young Adult

Publication Date

11-1-2017

Publication Title

Journal of cardiovascular electrophysiology

E-ISSN

1540-8167

Volume

28

Issue

11

First Page

1275

Last Page

1284

PubMed ID

28800179

Digital Object Identifier (DOI)

10.1111/jce.13311

Recommended Citation

Tripathi, Byomesh; Arora, Shilpkumar; Mishra, Abhishek; Kundoor, Vishwa Reddy; Lahewala, Sopan; Kumar, Varun; Shah, Mahek; Lakhani, Dhairya; Shah, Harshil; Patel, Nilay V.; Patel, Nileshkumar J.; Dave, Mihir; Deshmukh, Abhishek; Sudhakar, Sattur; and Gopalan, Radha, "Short-term outcomes of atrial flutter ablation" (2017). Neurology. 2085.
https://scholar.barrowneuro.org/neurology/2085