Trends in catheter ablation for atrial fibrillation in the United States.

BACKGROUND: There are few data on the use of catheter ablation for atrial fibrillation (AF) in the United States. We analyzed data from the National Hospital Discharge Survey (NHDS) to examine trends in the rate of catheter ablation for hospitalized patients with AF over a 15-year period.
OBJECTIVE: To examine rates of catheter ablation in patients with AF over time.
DESIGN: All adult patients in the NHDS with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for AF from the years 1990 to 2005 were identified and assessed for the presence of a cardiac catheter ablation procedure code. Clinical characteristics associated with ablation were identified and multivariable logistic regression used to determine trends in the rate of ablation therapy over time.
RESULTS: We identified 269,471 adults with AF. The rate of catheter ablation in AF patients increased from 0.06% in 1990 to 0.79% in 2005 (P < 0.001 for trend). Compared to those not undergoing ablation, ablated patients were younger (mean age 66 versus 76 years; P < 0.001), more likely to be male (57% versus 43%; P < 0.001), have private insurance (22% versus 11%; P < 0.001), and have a none of the following stroke risk factors: congestive heart failure, hypertension, age >75 years, diabetes mellitus, or stroke/transient ischemic attack (37% versus 16%; P < 0.001). Catheter ablation in AF patients increased by 15% per year over the time period (95% confidence interval [CI], 13%-16%) and across all age groups, including in patients age > or =80 years (0.0% in 1990 and 0.26% in 2005; P < 0.001 for trend).
CONCLUSIONS: The rate of catheter ablation in patients with AF is increasing significantly over time, even in the oldest patients. Medicine. Copyright 2009 Society of Hospital