Racial/Ethnic and Sex Differences in Outcomes after Catheter Ablation of Atrial Fibrillation

66 Pages Posted: 28 Dec 2021

See all articles by Larry Ronald Jackson II

Larry Ronald Jackson II

Duke University - Medical Center

Daniel Joseph Friedman

Duke University - Medical Center

Diane Francis

Johnson & Johnson Medical Devices, Health Economics and Market Access

Sonia Maccioni

Johnson & Johnson Medical Devices, Health Economics and Market Access

Vincent Thomas

Biosense Webster Inc

Jennifer Wood

Johnson & Johnson - Medical Device Epidemiology and Real-World Data Sciences

RAHUL KHANNA

Johnson & Johnson - Medical Device Epidemiology and Real-World Data Sciences

Charlene Wong

Johnson & Johnson - Medical Device Epidemiology and Real-World Data Sciences

Neloufar Rahai

Johnson & Johnson - Medical Device Epidemiology and Real-World Data Sciences

Jonathan P. Piccini

Duke University

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

Suggested Citation

Jackson II, Larry Ronald and Friedman, Daniel Joseph and Francis, Diane and Maccioni, Sonia and Thomas, Vincent and Wood, Jennifer and KHANNA, RAHUL and Wong, Charlene and Rahai, Neloufar and Piccini, Jonathan P., Racial/Ethnic and Sex Differences in Outcomes after Catheter Ablation of Atrial Fibrillation. Available at SSRN: https://ssrn.com/abstract=3995586 or http://dx.doi.org/10.2139/ssrn.3995586

Larry Ronald Jackson II

Duke University - Medical Center ( email )

NC
United States

Daniel Joseph Friedman

Duke University - Medical Center ( email )

NC
United States

Diane Francis

Johnson & Johnson Medical Devices, Health Economics and Market Access ( email )

Irvine, CA
United States

Sonia Maccioni

Johnson & Johnson Medical Devices, Health Economics and Market Access ( email )

Irvine, CA
United States

Vincent Thomas

Biosense Webster Inc ( email )

Irvine, CA
United States

Jennifer Wood

Johnson & Johnson - Medical Device Epidemiology and Real-World Data Sciences ( email )

Brunswick, NJ
United States

RAHUL KHANNA

Johnson & Johnson - Medical Device Epidemiology and Real-World Data Sciences ( email )

Brunswick, NJ
United States

Charlene Wong (Contact Author)

Johnson & Johnson - Medical Device Epidemiology and Real-World Data Sciences ( email )

Brunswick, NJ
United States

Neloufar Rahai

Johnson & Johnson - Medical Device Epidemiology and Real-World Data Sciences ( email )

Brunswick, NJ
United States

Jonathan P. Piccini

Duke University ( email )

Departments of Classical Studies & Philosophy
Durham, NC 27708
United States

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