Racial/Ethnic and Sex Differences in Outcomes after Catheter Ablation of Atrial Fibrillation
66 Pages Posted: 28 Dec 2021
Abstract
Background: Catheter ablation is recommended for the treatment of symptomatic atrial fibrillation (AF) refractory to medical therapy. We examined racial, ethnic and sex differences in complications and healthcare use following catheter ablation for AF.Methods: Centers for Medicare and Medicaid Services (CMS) Medicare Standard Analytical Files (SAF) database (October 1, 2014, to September 30, 2019) was used to identify patients 65 years of age or older with AF who underwent catheter ablation for rhythm control. We compared the risk of any complication within 30 days and AF-related acute healthcare utilization within one year of ablation among different racial, ethnic, and sex groups using multivariable cox regression modelling. Results: We identified 95,394 patients for analysis of post-ablation complications and 68,408 patients for the analysis of AF-related acute healthcare utilization. In both cohorts, the sample was ~95% White and 52% male. Female patients had a slightly elevated risk of complications as compared to male patients (adjusted Hazard Ratio [aHR] 1.09, 95% confidence interval [CI] 1.01-1.17). Black (aHR 0.78, 95% CI 0.67 - 0.91) and Asian (aHR 0.67, 95% CI 0.50 - 0.91) patients had lower AF-related acute healthcare utilization compared to White patients. Specifically, Black females (aHR 0.78, 95% CI 0.63-0.96) and Asian males (aHR 0.58, 95% CI 0.36-0.94) had lower utilization compared to White males.Conclusion: Differences in the safety and healthcare utilization after catheter ablation for AF were observed by race/ethnicity and sex groups. Underrepresented racial and ethnic groups with AF had a lower risk of AF-related utilization post-ablation.
Keywords: catheter ablation, atrial fibrillation, retrospective database, healthcare utilization
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