Combined atrial fibrillation ablation and left atrial appendage occlusion procedure in the United States: a propensity score matched analysis from 2016-2019 national readmission database

Deepak Kumar Pasupula; Sudeep K Siddappa Malleshappa; Muhammad B Munir; Anusha Ganapati Bhat; Antony Anandaraj; Avaneesh Jakkoju; Michael Spooner; Ketan Koranne; Jonathan C Hsu; Brian Olshansky; A John Camm

doi:10.1093/europace/euac181

Back

Combined atrial fibrillation ablation and left atrial appendage occlusion procedure in the United States: a propensity score matched analysis from 2016-2019 national readmission database

Journal article

Open access

Peer reviewed

Combined atrial fibrillation ablation and left atrial appendage occlusion procedure in the United States: a propensity score matched analysis from 2016-2019 national readmission database

Deepak Kumar Pasupula, Sudeep K Siddappa Malleshappa, Muhammad B Munir, Anusha Ganapati Bhat, Antony Anandaraj, Avaneesh Jakkoju, Michael Spooner, Ketan Koranne, Jonathan C Hsu, Brian Olshansky, …

Europace (London, England), Vol.25(2), pp.390-399

02/16/2023

DOI: 10.1093/europace/euac181

PMCID: PMC9935040

PMID: 36350997

Files and links (1)

url

https://doi.org/10.1093/europace/euac181View

Published (Version of record) Open Access

Abstract

The safety and feasibility of combining percutaneous catheter ablation (CA) for atrial fibrillation with left atrial appendage occlusion (LAAO) as a single procedure in the USA have not been investigated. We analyzed the US National Readmission Database (NRD) to investigate the incidence of combined LAAO + CA and compare major adverse cardiovascular events (MACEs) with matched LAAO-only and CA-only patients. In this retrospective study from NRD data, we identified patients undergoing combined LAAO and CA procedures on the same day in the USA from 2016 to 2019. A 1:1 propensity score match was performed to identify patients undergoing LAAO-only and CA-only procedures. The number of LAAO + CA procedures increased from 28 (2016) to 119 (2019). LAAO + CA patients (n = 375, mean age 74 ± 9.2 years, 53.4% were males) had non-significant higher MACE (8.1%) when compared with LAAO-only (n = 407, 5.3%) or CA-only patients (n = 406, 7.4%), which was primarily driven by higher rate of pericardial effusion (4.3%). All-cause 30-day readmission rates among LAAO + CA patients (10.7%) were similar when compared with LAAO-only (12.7%) or CA-only (17.5%) patients. The most frequent primary reason for readmissions among LAAO + CA and LAAO-only cohorts was heart failure (24.6 and 31.5%, respectively), while among the CA-only cohort, it was paroxysmal atrial fibrillation (25.7%). We report an 63% annual growth (from 28 procedures) in combined LAAO and CA procedures in the USA. There were no significant difference in MACE and all-cause 30-day readmission rates among LAAO + CA patients compared with matched LAAO-only or CA-only patients.

Aged

Aged, 80 and over

Atrial Appendage - surgery

Atrial Fibrillation - complications

Atrial Fibrillation - diagnosis

Atrial Fibrillation - surgery

Catheter Ablation - adverse effects

Female

Humans

Male

Middle Aged

Patient Readmission

Propensity Score

Retrospective Studies

Stroke - etiology

Treatment Outcome

United States - epidemiology

Details

Title: Subtitle: Combined atrial fibrillation ablation and left atrial appendage occlusion procedure in the United States: a propensity score matched analysis from 2016-2019 national readmission database
Creators: Deepak Kumar Pasupula - Division of Cardiovascular Disease, Department of Internal Medicine, MercyOne North Iowa Medical Center, 1000 4th St SW, Mason City, IA 50401, USA
Sudeep K Siddappa Malleshappa - Division of Haematology-Oncology, Department of Internal Medicine, UMass Chan-Baystate, 759 Chestnut St, Springfield, MA 01199, USA
Muhammad B Munir - University of California, Davis
Anusha Ganapati Bhat - University of Maryland, Baltimore
Antony Anandaraj - Mercy Medical Center
Avaneesh Jakkoju - Cardiovascular Institute of the South
Michael Spooner - Mercy Medical Center
Ketan Koranne - Mercy Medical Center
Jonathan C Hsu - University of California San Diego
Brian Olshansky - University of Iowa, Internal Medicine
A John Camm - St George's, University of London
Resource Type: Journal article
Publication Details: Europace (London, England), Vol.25(2), pp.390-399
DOI: 10.1093/europace/euac181
PMID: 36350997
PMCID: PMC9935040
NLM abbreviation: Europace
ISSN: 1099-5129
eISSN: 1532-2092
Language: English
Date published: 02/16/2023
Academic Unit: Internal Medicine
Record Identifier: 9984473219702771

Metrics

19 Record Views

21 Times Cited - Web of Science