Intracardiac echocardiography may prevent HF readmission after AF ablation
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Intracardiac echocardiography use during ablation for atrial fibrillation reduced readmissions at 90 days by 12%, driven by a 24% decrease in HF‐related admissions, researchers reported.
“Intracardiac echocardiography is useful in preventing recurrent admissions due to HF within 90 days of inpatient admission after undergoing AF ablation,” Deepak Padmanabhan, DM, of the department of cardiac electrophysiology at Sri Jayadeva Institute of Cardiac Sciences and Research in Bangalore, India, told Healio. “There may be justification for the use of intracardiac echocardiography for the purposes of performing AF ablation.”
Padmanabhan and colleagues analyzed data from 51,129 adults who underwent catheter ablation for AF from 2010 to 2017, identified from the Nationwide Readmissions Database, including 8,005 who underwent intracardiac echocardiography. Researchers used propensity matching to generate a control group and assessed patient demographics, Charlson Comorbidity Index, time from discharge to readmission and reason for readmission.
The findings were published in the Journal of Cardiovascular Electrophysiology.
Compared with patients who did not undergo intracardiac echocardiography, those who did were more likely to be younger (mean age, 65 vs. 67 years; P < .0001), were more likely to be men (66.9% vs. 64.8%; P < .0001) and had fewer comorbidities (median Charlson Comorbidity Index, 0 points vs. 1 point; P < .0001).
Researchers found that in‐hospital mortality at readmission was higher among patients without intracardiac echocardiography use (2.9% vs. 1.7%; P = .02). Additionally, among patients who did not undergo intracardiac echocardiography, median length of stay at readmission was higher (3 days vs. 2 days; P < .0001) with similar median health care‐associated costs across the two groups ($7,507.30 vs. $7,339.40; P = .43).
Freedom from readmission was 12% higher with the use of intracardiac echocardiography at 90‐day follow‐up (HR = 0.88; 95% CI, 0.83-0.94; P < .0001), which was driven by a 24% reduction in HF at follow‐up (HR = 0.76; 95% CI, 0.6-0.96; P = .02).
“We need to review the use of intracardiac echocardiography in other arrhythmias,” Padmanabhan told Healio. “Additionally, there is value in understanding the role of 3D intracardiac echocardiography in AF ablation.”
For more information:
Deepak Padmanabhan, DM, can be reached at deepak.padmanabhan@gmail.com.
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