Narut Prasitlumkum1, Ronpichai Chokesuwattanaskul2, Wisit Kaewput3, Charat Thongprayoon3, Nithi Tokavanich2, Tarun Bathini4, Boonphiphop Boonpheng5, Saraschandra Vallabhajosyula6, Wisit Cheungpasitporn3, Krit Jongnarangsin7. 1. Department of Cardiology, University of California Riverside, Riverside, California, USA. 2. Division of Cardiovascular Medicine, Department of Medicine, Cardiac Center, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. 3. Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA. 4. Department of Internal Medicine, University of Arizona, Tucson, Arizona, USA. 5. Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA. 6. Department of Medicine, Section of Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. 7. Division of Cardiac Electrophysiology, University of Michigan Health Care, Ann Arbor, Michigan, USA.
Abstract
INTRODUCTION: Real-world data on atrial fibrillation (AF) ablation among moderate and advanced chronic kidney disease (CKD) patients have so far remained scarce, especially in-hospital AF ablation outcomes. METHODS: We drew data from the US National Inpatient Sample to identify hospitalized patients who underwent AF ablation between 2005 and 2018, and further stratified by CKD classification. We assessed the trend of AF ablation, as well as its complications. RESULTS: A total of 152 630 patients who were primarily hospitalized for AF and underwent ablation were estimated. Among these, CKD patients were found in a total of 1509 participants, with 978, 206, and 325 under CKD3, CKD4, and CKD5/ESKD, respectively. There was a significant increment in admission rates for AF ablation in the CKD population across all CKD classifications (p < .001). All CKD patients were statistically older, with higher coexisting comorbidities, while hypertension was found substantially lower than non-CKD patients (p ≤ .001). Importantly, CKD, especially CKD3 and CKD5/ESKD, was significantly associated with an increased risk of total complications, and total bleeding, Neurological complications were found statistically lower in CKD patients (p = .029), and no mortality rates were significantly different (p = .287). CONCLUSION: Our study observed an increase in admission trends for AF ablation among moderate and advanced CKD patients from 2005 to 2018. CKD was strongly associated with higher procedure-related complications and bleeding, but neurological safety profiles and mortalities rates were nonsignificantly different.
INTRODUCTION: Real-world data on atrial fibrillation (AF) ablation among moderate and advanced chronic kidney disease (CKD) patients have so far remained scarce, especially in-hospital AF ablation outcomes. METHODS: We drew data from the US National Inpatient Sample to identify hospitalized patients who underwent AF ablation between 2005 and 2018, and further stratified by CKD classification. We assessed the trend of AF ablation, as well as its complications. RESULTS: A total of 152 630 patients who were primarily hospitalized for AF and underwent ablation were estimated. Among these, CKD patients were found in a total of 1509 participants, with 978, 206, and 325 under CKD3, CKD4, and CKD5/ESKD, respectively. There was a significant increment in admission rates for AF ablation in the CKD population across all CKD classifications (p < .001). All CKD patients were statistically older, with higher coexisting comorbidities, while hypertension was found substantially lower than non-CKD patients (p ≤ .001). Importantly, CKD, especially CKD3 and CKD5/ESKD, was significantly associated with an increased risk of total complications, and total bleeding, Neurological complications were found statistically lower in CKD patients (p = .029), and no mortality rates were significantly different (p = .287). CONCLUSION: Our study observed an increase in admission trends for AF ablation among moderate and advanced CKD patients from 2005 to 2018. CKD was strongly associated with higher procedure-related complications and bleeding, but neurological safety profiles and mortalities rates were nonsignificantly different.
Authors: Giuseppe Boriani; Saverio Iacopino; Giuseppe Arena; Paolo Pieragnoli; Roberto Verlato; Massimiliano Manfrin; Giulio Molon; Giovanni Rovaris; Antonio Curnis; Giovanni Battista Perego; Antonio Dello Russo; Maurizio Landolina; Marco Vitolo; Claudio Tondo Journal: J Cardiovasc Dev Dis Date: 2022-04-21