Association Between Stable Coronary Artery Disease and Hospital Readmissions Following Catheter Ablation for Atrial Fibrillation

Mayo Clin Proc. 2023 Jun;98(6):892-902. doi: 10.1016/j.mayocp.2023.01.011. Epub 2023 Apr 29.

Abstract

Objective: To evaluate the association of stable coronary artery disease (CAD) with readmission following hospitalization for catheter ablation (CA) for atrial fibrillation (AF).

Patients and methods: Using the Nationwide Readmissions Database, we identified all hospitalizations from the last quarter of 2015 through 2019 with a Medicare Severity-Diagnosis Related Group designation for a percutaneous intracardiac procedure, a procedure code for CA, and a primary discharge diagnosis of AF. Cases of acute coronary syndrome (ACS) at index hospitalization were excluded to define stable CAD. The primary outcome was all-cause 90-day hospital readmission; secondary end points included readmissions for AF, repeated CA, ACS, and heart failure (HF).

Results: Among 28,466 hospitalizations for CA for AF identified, 3171 (11.1%) involved patients with stable CAD. No hospitalizations included patients with HF diagnosis codes. The incidence of 90-day all-cause readmission was higher in patients with stable CAD (18.4% [400 of 2172] vs 14.4% [2549 of 17,667]; P=.006), as was the incidence of subsequent hospitalization with ACS (5.3% [21] vs 1.1% [28]; P<.001) or HF (17.0% [68] vs 10.2% [260]; P=.007). The incidence of readmission within 90 days with recurrent AF did not differ for those with or without stable CAD (21.9% [88] vs 26.5% [675]; P=.217). Pooled analysis of 90-day HF readmissions revealed a higher incidence among older patients, those with chronic kidney or pulmonary disease, and those with persistent and chronic AF subtypes.

Conclusion: Results of this large-scale analysis suggest that among patients hospitalized for CA for AF, stable CAD is associated with hospital readmissions within 90 days, including admissions for ACS and decompensated HF.

MeSH terms

  • Aged
  • Atrial Fibrillation* / diagnosis
  • Atrial Fibrillation* / epidemiology
  • Atrial Fibrillation* / surgery
  • Catheter Ablation* / adverse effects
  • Catheter Ablation* / methods
  • Coronary Artery Disease* / complications
  • Coronary Artery Disease* / epidemiology
  • Coronary Artery Disease* / surgery
  • Heart Failure*
  • Humans
  • Medicare
  • Neoplasm Recurrence, Local / surgery
  • Patient Readmission
  • Retrospective Studies
  • Risk Factors
  • United States / epidemiology