Arrhythmias & electrophysiology
In-hospital complications associated with pulmonary vein isolation with adjunctive lesions: the NCDR AFib Ablation Registry
Authors' conclusion
Additional CTI ablation was common without an increased risk of complications. Adjunctive lesions other than CTI are commonly performed in those with more comorbidities and were associated with an increased risk of complications in persistent AF, although the current analysis is limited by high heterogeneity in adjunctive lesion set type.
Study context
- Population
- Patients undergoing first-time atrial fibrillation (AF) ablation in the NCDR AFib Ablation Registry, 2016–2020, stratified into paroxysmal (PAF) and persistent AFPAF 30,551
- Participants
- 50,937 patients
- Exposure
- Pulmonary vein isolation (PVI) + cavotricuspid isthmus (CTI) or PVI + adjunctive lesions vs PVI only
- Outcome
- In-hospital complications (adjusted odds of adverse events)
- Follow-up
- In-hospital
Methodological detailsregistry-based, multivariable logistic regression
- Registry-based
- Multivariable logistic regression
Main finding
As reported in the abstract
In-hospital complications
PVI + adjunctive vs PVI onlyOdds ratio (95% CI)
Persistent AF, any complication: 4.5 vs 3.0%
1.30(1.07–1.58)
Persistent AF, major complication: 1.4 vs 0.8%
1.56(1.10–2.21)
Observational data: associations, not effects.
Further findings
Patient characteristics
- High heterogeneity in adjunctive lesion type; adjunctive lesion recipients had higher comorbidity burden
Original publication
In-hospital complications associated with pulmonary vein isolation with adjunctive lesions: the NCDR AFib Ablation Registry. Europace. Published 15 May 2023. doi:10.
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