Abstract 14989: The Importance of an Atrial Fibrillation Center to Manage Patients Before and After Catheter Ablation for Atrial Fibrillation

Abstract

Introduction: Patients eligibility for catheter ablation of atrial fibrillation (AF) is markedly increasing. The procedure is now available also for patients with structural heart disease and non-paroxysmal AF. However, success rates and peri-procedural complication rates still represent an important issue. We present data comparing re-hospitalization and complications after AF ablation performed with and without the support of allied health professionals as part of an arrhythmia center.

Methods: Peri-procedural outcomes of one thousands two hundred forty four patients undergoing catheter ablation for AF at our Institution with the support of an AF center were cross matched with a similar group of patients undergoing ablation at our Institutions without the support of an AF center. Data were analyzed and compared.

Results: The number of patients reaching the procedure on therapeutic INR was 43% vs 94%; the number of pts needing pre-procedural TEE was 66% vs 16% (P<0.001); the percentage of vascular access complication dropped from 19% to 4 % ( P<0.001); the prevalence of fluid overload dropped from 15% to 4% ( P<0.001). Overall the hospital stay following ablation dropped from a median of 3 days to an overnight stay. Importantly the procedural related hospitalization dropped from 5.7% to 1% (P<0.005) and the overall all cause Re-Hospitalization at 1 year dropped from 36% to 23% (P<0.005) (figure).

Conclusion: Direct access to expert allied health professionals within a structured arrhythmia center is helpful in improving compliance to treatment and reducing re-hospitalization after catheter ablation of atrial fibrillation.