TY - JOUR
T1 - Initial Findings From the National Cardiovascular Data Registry of Atrial Fibrillation Ablation Procedures
AU - Hsu, Jonathan C.
AU - Darden, Douglas
AU - Du, Chengan
AU - Marine, Joseph E.
AU - Nichols, Sheila
AU - Marcus, Gregory M.
AU - Natale, Andrea
AU - Noseworthy, Peter A.
AU - Selzman, Kimberly A.
AU - Varosy, Paul
AU - Masoudi, Frederick
AU - Freeman, James
AU - Curtis, Jeptha
AU - Akar, Joseph
AU - Kowey, Peter R.
N1 - Publisher Copyright:
© 2023 American College of Cardiology Foundation
PY - 2023/3/7
Y1 - 2023/3/7
N2 - Background: The National Cardiovascular Data Registry (NCDR) AFib Ablation Registry was created to assess real-world prevalence, demographic characteristics, procedural management, and outcomes of patients undergoing atrial fibrillation (AF) ablation procedures. Objectives: The goal of this study was to characterize the patient, hospital, and physician characteristics and in-hospital outcomes related to AF ablation in the first 5 years of the registry. Methods: This paper describes the AFib Ablation Registry structure and governance, outcome assessment processes, data quality, and data collection processes. The characteristics of the patient population, hospitals, and in-hospital outcomes are also described. Results: A total of 76,219 patients were included in the registry between January 2016 and December 2020 (mean age 65.5 ± 10.3 years, 65.2% male, 55.8% paroxysmal AF, mean CHA2DS2-VASc score 2.7 ± 1.6) treated by 708 physicians in 162 hospitals. Successful isolation of all pulmonary veins was achieved in 92.4% of patients. The prevalence of any complication during procedural admission was 2.50% and major complication was 0.9%, including significant bradycardia in 0.47%, heart failure in 0.47%, and pericardial effusion requiring intervention in 0.44%. Hospitalization >1 day occurred in 11.8% of patients, and in-hospital death was rare (n = 41 [0.05%]). Conclusions: The NCDR AFib Ablation Registry is the largest multicenter, prospective cohort study of patients undergoing catheter ablation worldwide. Results in the first 5 years showed that successful pulmonary vein isolation is achieved in the majority of patients, with a low rate of complications. Future studies from the registry will assess practice trends, evaluate treatment patterns associated with different patient outcomes, and support development of evidence-based guidelines.
AB - Background: The National Cardiovascular Data Registry (NCDR) AFib Ablation Registry was created to assess real-world prevalence, demographic characteristics, procedural management, and outcomes of patients undergoing atrial fibrillation (AF) ablation procedures. Objectives: The goal of this study was to characterize the patient, hospital, and physician characteristics and in-hospital outcomes related to AF ablation in the first 5 years of the registry. Methods: This paper describes the AFib Ablation Registry structure and governance, outcome assessment processes, data quality, and data collection processes. The characteristics of the patient population, hospitals, and in-hospital outcomes are also described. Results: A total of 76,219 patients were included in the registry between January 2016 and December 2020 (mean age 65.5 ± 10.3 years, 65.2% male, 55.8% paroxysmal AF, mean CHA2DS2-VASc score 2.7 ± 1.6) treated by 708 physicians in 162 hospitals. Successful isolation of all pulmonary veins was achieved in 92.4% of patients. The prevalence of any complication during procedural admission was 2.50% and major complication was 0.9%, including significant bradycardia in 0.47%, heart failure in 0.47%, and pericardial effusion requiring intervention in 0.44%. Hospitalization >1 day occurred in 11.8% of patients, and in-hospital death was rare (n = 41 [0.05%]). Conclusions: The NCDR AFib Ablation Registry is the largest multicenter, prospective cohort study of patients undergoing catheter ablation worldwide. Results in the first 5 years showed that successful pulmonary vein isolation is achieved in the majority of patients, with a low rate of complications. Future studies from the registry will assess practice trends, evaluate treatment patterns associated with different patient outcomes, and support development of evidence-based guidelines.
KW - National Cardiovascular Data Registry
KW - atrial fibrillation
KW - outcomes
KW - percutaneous catheter ablation
KW - prospective registry
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U2 - 10.1016/j.jacc.2022.11.060
DO - 10.1016/j.jacc.2022.11.060
M3 - Article
C2 - 36858707
AN - SCOPUS:85149067211
SN - 0735-1097
VL - 81
SP - 867
EP - 878
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 9
ER -