Abstract 2099: Characteristics of Patients Referred for Atrial Fibrillation Ablation Over a 7 year period: Increasing Incidence of Persistent AF and Continued Under-referral of Women
Background: As the technique of atrial fibrillation (AF) ablation has evolved, the patient population referred for this procedure has rapidly expanded. We examined characteristics of patients undergoing AF ablation at our institution over a 7-year period 1999 through 2005.
Methods: Patients referred from 1999 –2000 underwent focal ablation of triggers within the pulmonary vein (PV); patients referred since 2001 have undergone PV isolation and ablation of non-PV triggers. For comparison, we screened all outpatients seen in the primary care clinic with a diagnosis of AF during the study period (N = 32,427), as well as patients referred to the arrhythmia clinic for ablation in 2005 (N = 219) . Trends were assessed using ANOVA for continuous variables or Kruskal-Wallis H test for ordinal variables.
Results: From 1/99 to 12/05, 1,011 AF ablation procedures were performed. Patients have become progressively older, with larger left atrial (LA) size, more persistent/permanent AF, and fewer prior antiarrhythmic (AA) drugs used (see Table⇓). There was no change in the gender of patients undergoing ablation over time. There were significantly more males who underwent AF ablation then who were seen in primary care clinic with AF (77 vs. 59% male; P < 0.001). However, there was no difference between the gender of patients referred for ablation and those who underwent ablation (77 vs 77% male; P=NS). Other characteristics including prior duration of AF (7.1 yrs), presence of EF ≤ 45% (9%), coronary artery disease (10%), and weight (207 lbs) have remained unchanged during this time period (number reflects average over 7 years).
Conclusions: The population characteristics for patients undergoing AF ablation over the last 7 years suggest 1) that patients have become older, with larger LA size and more persistent/permanent AF; 2) women have been consistently under-referred for AF ablation compared to men. The reasons why fewer women are referred for AF ablation requires further investigation.