Arrhythmias & electrophysiology
Procedural volume and outcomes with atrial fibrillation ablation: A report from the NCDR AFib Ablation Registry
Authors' conclusion
In this national cohort, hospital and physician AF ablation procedural volumes were directly related to acute procedural success and inversely related to rates of MAE.
Study context
- Population
- First-time atrial fibrillation (AF) ablations in the NCDR AFib Ablation Registry, 186 US hospitals, July 2019–June 2022
- Participants
- 70,296 participants186 US hospitals
- Exposure
- Hospital and physician AF ablation volume quartiles
- Outcome
- Procedural success (isolation of all pulmonary veins) and major adverse events (MAEs)
Methodological detailsthree-level hierarchical models, national registry
- Three-level hierarchical models
- National registry
Main finding
As reported in the abstract
Procedural success, by hospital volume
Each group vs Q4Odds ratio (95% CI)
Q1
0.44(0.29–0.68)
Q2
0.50(0.33–0.75)
Q3
0.60(0.40–0.89)
- Overall procedural success
- 98.5%
Observational data: associations, not effects.
Further findings
Volume predicting adjusted MAE ≤1%
- Annual hospital volume
- ≈190
- Annual physician volume
- 60
Safety
| Outcome | OR (95% CI) | |
|---|---|---|
| MAE, by hospital volumeQ1vs Q4Hospital volume | 1.78 (1.26–2.52) | |
| MAE, by hospital volumeQ2vs Q4Hospital volume | 1.06 (0.77–1.46) | |
| MAE, by hospital volumeQ3vs Q4Hospital volume | 1.19 (0.89–1.58) | |
| 0.20.5125Odds ratio (log scale) |
- MAE, by hospital volume — Overall MAE rate
- 1.0%
MAE, by hospital volume
- Physicians: inverse relationship in Q1 and Q2 but not Q3
Original publication
Procedural volume and outcomes with atrial fibrillation ablation: A report from the NCDR AFib Ablation Registry. Heart Rhythm. Published 2 July 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →