Long- term outcomes following endocardial and epicardial ablation of atrial fibrillation in a low procedural volume hospital

Abstract

Atrial Fibrillation (AFib) ablation volume and its relation to outcomes posit negatively for low volume centers, the ideal annual hospital volume is 50. Fifty four in-patients have been followed. The primary outcome is the change in an AFib validated outcomes questionnaire that subjects completed pre-procedure, 6 months, 1 year, and annually thereafter. Secondary endpoints included duration of maintaining normal sinus rhythm (NSR) and adverse events. At 6 months, the overall questionnaire score improved by 30 points from the baseline score (95% CI: (16, 43), p < 0.001). The improvement from baseline was also maintained at 1 year, with the 1-year change score of 22 points (95% CI: (14, 30), p < 0.001), additionally significant improvements were observed in each of the subscales. Based on a Kaplan-Meier analysis, 96% of subjects maintained NSR at 6 months, 87% maintained NSR at 1 year, and 78% maintained NSR at 2 years. Epicardial and endocardial ablation for AF care is feasible in a low-volume ablation hospital with careful long-term tracking. Patients can receive quality care closer to home and not incur costs associated with traveling for health care-a determinate of value- based care.