Atrial Fibrillation Catheter Ablation Complications in Obese and Diabetic Patients: Nationwide Inpatient Sample 2005-2013

33 Pages Posted: 15 Dec 2020

See all articles by Shawn D’Souza

Shawn D’Souza

Weill Cornell Medicine-Qatar

Mohamed, B. Elshazly

Weill Cornell Medicine in Qatar

Soha, R. Dargham

Weill Cornell Medicine-Qatar

Eoin Donnellan

Cleveland Clinic Foundation

Nidal Asaad

Hamad Medical Corporation - Adult Cardiology

Sajad, A. Hayat

Joan and Sanford I. Weill Department of Medicine. Weill Cornell Medicine

Mohamed Kanj

Cleveland Clinic Foundation

Bryan Baranowski

Cleveland Clinic - Section of Cardiac Pacing and Electrophysiology

Oussama Wazni

Cleveland Clinic - Section of Cardiac Pacing and Electrophysiology

Walid I. Saliba

Cleveland Clinic - Section of Cardiac Pacing and Electrophysiology

Charbel Abi Khalil

Weill Cornell Medicine-Qatar

Abstract

Abstract:Background: Obesity and diabetes are risk factors for atrial fibrillation (AF) incidence and recurrence after catheter ablation. However, their impact on post-ablation complications in real-world practice is unknown.Objectives: We examine annual trends in AF ablations and procedural outcomes in obese and diabetic patients in the US and whether obesity and diabetes are independently associated with adverse outcomes.Methods: Using the Nationwide Inpatient Sample (2005-2013), we identified obese and diabetic patients admitted for AF ablation. Common complications were identified using ICD-9-CM codes. The primary outcome included the composite of any in-hospital complication or death. Annual trends of the primary outcome, length-of-stay (LOS) and total-inflation adjusted hospital charges were examined. Multivariate analyses studied the association of obesity and diabetes with outcomes.Results: An estimated 106,462 AF ablations were performed in the US from 2005-2013. Annual trends revealed a gradual increase in ablations performed in obese and diabetic patients and in complication rates. The overall rate of the primary outcome in obese was 11.7% vs. 8.2% in non-obese and 10.7% in diabetic vs. 8.2% in non-diabetic patients (p<0.001). Obesity was independently associated with increased complications (adjusted OR, 95% CI:1.39, 1.20 - 1.62), longer LOS (1.36, 1.23 - 1.49), and higher charges (1.16, 1.12 - 1.19). Diabetes was only associated with longer LOS (1.27, 1.16 - 1.38). Conclusions: Obesity, but not diabetes, in patients undergoing AF ablation is an independent risk factor for immediate post-ablation complications and higher costs. Future studies should investigate whether weight loss prior to ablation reduces complications and costs.

Suggested Citation

D’Souza, Shawn and Elshazly, Mohamed, B. and Dargham, Soha, R. and Donnellan, Eoin and Asaad, Nidal and Hayat, Sajad, A. and Kanj, Mohamed and Baranowski, Bryan and Wazni, Oussama and Saliba, Walid I. and Abi Khalil, Charbel, Atrial Fibrillation Catheter Ablation Complications in Obese and Diabetic Patients: Nationwide Inpatient Sample 2005-2013. Available at SSRN: https://ssrn.com/abstract=3749013 or http://dx.doi.org/10.2139/ssrn.3749013

Shawn D’Souza

Weill Cornell Medicine-Qatar ( email )

Mohamed, B. Elshazly (Contact Author)

Weill Cornell Medicine in Qatar ( email )

Qatar

Soha, R. Dargham

Weill Cornell Medicine-Qatar ( email )

Eoin Donnellan

Cleveland Clinic Foundation

OH
United States

Nidal Asaad

Hamad Medical Corporation - Adult Cardiology

Qatar

Sajad, A. Hayat

Joan and Sanford I. Weill Department of Medicine. Weill Cornell Medicine ( email )

Mohamed Kanj

Cleveland Clinic Foundation

OH
United States

Bryan Baranowski

Cleveland Clinic - Section of Cardiac Pacing and Electrophysiology ( email )

9500 Euclid Ave.
Cleveland, OH 44195
United States

Oussama Wazni

Cleveland Clinic - Section of Cardiac Pacing and Electrophysiology ( email )

Walid I. Saliba

Cleveland Clinic - Section of Cardiac Pacing and Electrophysiology ( email )

Cleveland, OH
United States

Charbel Abi Khalil

Weill Cornell Medicine-Qatar ( email )

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