Trend Analyses on Interventional Treatment of Atrial Fibrillation From 2016 to 2022: Insights From a Multicenter Hospital Database of Left Atrial Catheter Ablation Cases.
Current real-world data on the utilization of atrial fibrillation (AF) catheter ablation (CA) are scarce, as is information on the impact of the COVID-19 pandemic on trends in interventional AF treatment. Aims of this study were to describe case characteristics and trends of CA management using a contemporary multicenter database.
In this retrospective, cross-sectional analysis, we investigated administrative data provided by 87 German hospitals from 01/01/2016 to 12/15/2022. Based on ICD-10 and OPS codes, inpatient cases with a main or secondary discharge diagnosis of AF who underwent CA were extracted. Incidence-rate ratios (IRR) for case numbers with 95% confidence intervals (CI) were calculated using negative binomial models. Trends based on regression analysis were adjusted for baseline variables.
Analyzing 29 144 CA cases (89.4% from high-volume centers), a significant increase in case numbers was observed throughout the study period (IRR 1.05, 95% CI 1.03-1.07, p < 0.001). There was no sustained impact on the overall trend from the COVID-19 pandemic, but a temporary drop in case numbers in 2020. Utilization of transesophageal echocardiography (OR 0.82, 95% CI 0.81-0.83, p < 0.001) and intensive care treatment declined (OR 0.92, 95% CI 0.89-0.94, p < 0.001) and there was a trend toward a reduced incidence of pericardial tamponade. The ratio of cryoablations to radiofrequency CA case numbers increased from 0.29 ± 0.06 in 2016 to 0.50 ± 0.07 in 2022.
We observed an increase in AF CA case numbers over the study period without a sustained influence of the COVID-19 pandemic on this long-term trend. Reported adaptations in CA management deserve further attention.
In this retrospective, cross-sectional analysis, we investigated administrative data provided by 87 German hospitals from 01/01/2016 to 12/15/2022. Based on ICD-10 and OPS codes, inpatient cases with a main or secondary discharge diagnosis of AF who underwent CA were extracted. Incidence-rate ratios (IRR) for case numbers with 95% confidence intervals (CI) were calculated using negative binomial models. Trends based on regression analysis were adjusted for baseline variables.
Analyzing 29 144 CA cases (89.4% from high-volume centers), a significant increase in case numbers was observed throughout the study period (IRR 1.05, 95% CI 1.03-1.07, p < 0.001). There was no sustained impact on the overall trend from the COVID-19 pandemic, but a temporary drop in case numbers in 2020. Utilization of transesophageal echocardiography (OR 0.82, 95% CI 0.81-0.83, p < 0.001) and intensive care treatment declined (OR 0.92, 95% CI 0.89-0.94, p < 0.001) and there was a trend toward a reduced incidence of pericardial tamponade. The ratio of cryoablations to radiofrequency CA case numbers increased from 0.29 ± 0.06 in 2016 to 0.50 ± 0.07 in 2022.
We observed an increase in AF CA case numbers over the study period without a sustained influence of the COVID-19 pandemic on this long-term trend. Reported adaptations in CA management deserve further attention.
Authors
König König, Hohenstein Hohenstein, Leiner Leiner, Nitsche Nitsche, Baberg Baberg, Wiedemann Wiedemann, Seyfarth Seyfarth, Sause Sause, Staudt Staudt, Reithmann Reithmann, Wunderlich Wunderlich, Tebbenjohanns Tebbenjohanns, Shin Shin, Steinborn Steinborn, Niehaus Niehaus, Bode Bode, Bollmann Bollmann
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