Arrhythmias & electrophysiologyCohort study
Safety and effectiveness of zero-fluoroscopy atrial fibrillation ablation in community hospitals vs tertiary centers
- retrospective analysis
- propensity score matching
Authors' conclusion
Ablation of PAF at CHs with ZF is safe with a shorter DAB and decrease AF recurrences when compared with TH.
Study context
- Population
- Patients evaluated at 2 community hospitals undergoing zero-fluoroscopy pulmonary vein isolation for paroxysmal AF, ablated at a tertiary hospital (2015–2017) or at community hospitals (2017–2021)2 matched cohorts of 290 patients
- Participants
- 290 patients
- Exposure
- Paroxysmal AF (PAF) ablation with zero-fluoroscopy (ZF) at community hospitals (CHs) vs TH
Main finding
As reported in the abstract
Intraprocedural complications or transfers
- No intraprocedural complications or transfers occurred
Observational data: associations, not effects.
Further findings
| Outcome | Values | HR (95% CI) | P value | |
|---|---|---|---|---|
| AF recurrence predicted by DAB · 18 m — Longer DAB vs DAB <3 m | 2.63 (1.65–4.21) | |||
| AF recurrence predicted by DAB · 18 m — DAB = 6-9 m vs DAB <3 m | 3.13 (2.136–3.13) | |||
| AF recurrence predicted by DAB · 18 m — DAB >9 m vs DAB <3 m | 3.7 (2.30–3.75) | |||
| 0.20.5125Hazard ratio (log scale) |
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| AF recurrence · 12 m · lower with CH | CH 17% · TH 29% | P = 0.010 | |
| AF recurrence · 18 m · lower with CH | CH 23% · TH 42% | P = 0.05 | |
| Diagnosis-to-ablation time (DAB) · shorter with CH | CH 6.1 ± 1.2 m · TH 12.4 ± 2.5 m | P = 0.01 | |
| Same-day discharge · higher with CH | CH 93% · TH 70% | P = 0.010 | |
| Repeat ablation · higher in TH | TH 27% · CH 7% | P = 0.01 |
AF recurrence · 24 m
- AF recurrence was similar at 24 m
- 20%
Original publication
Safety and effectiveness of zero-fluoroscopy atrial fibrillation ablation in community hospitals vs tertiary centers. Heart Rhythm. Published 19 March 2026. doi:10.1016/j.hrthm.2026.03.1896
Summarised from the published abstract; every number is checked against it