Objective: The purpose of this study was to examine the relationship between hospital volume of prior THERMOCOOL SMARTTOUCH catheter use and health and economic outcomes among hospitalized patients with atrial fibrillation (AF) undergoing ablation using this device.
Materials And Methods: Patients aged ≥18 years with a primary diagnosis of AF undergoing ablation treatment using the THERMOCOOL SMARTTOUCH catheter between January 2014 and June 2016 were identified from the Premier hospital database with the first date of such a procedure being defined as the index date. Hospital volume of prior THERMOCOOL SMARTTOUCH catheter use was determined during the 12-month pre-index period, and was classified into five groups: no volume (0), low volume (1-50), mid volume (51-100), high volume (101-150), and very high volume (≥151). Outcomes, including length of stay (LOS; for inpatient procedure only), hospital costs (total, hospital pharmacy, supply), and all-cause re-admission were evaluated. A generalized estimating equation (GEE) with exchangeable correlation structure was used to examine the impact of hospital volume on LOS, hospital costs, and re-admissions controlling for hospital clustering and other covariates.
Results: The study population included 640 hospitalized AF patients. The adjusted mean LOS was significantly shorter in very high-volume hospitals than hospitals with no volume (mean LOS 2.30 vs 4.33 days; p = .0377). As volume increased, the mean adjusted supply cost tended to decrease, although these changes emerged as non-significant. The 12-month all-cause re-admission was significantly lower among patients undergoing ablation in low (Odds ratio [OR] = 0.27; confidence interval [CI] = 0.08-0.85) and mid (OR = 0.12; CI = 0.02-0.61) volume hospitals compared to hospitals with no volume.
Limitations: Study results may not be generalizable to all US hospitals.
Conclusions: Among AF patients undergoing ablation, increased hospital volume of prior THERMOCOOL SMARTTOUCH catheter use was associated with shorter LOS and a lower likelihood of all-cause re-admission.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1080/13696998.2018.1423566 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Acute procedural safety of the latest radiofrequency ablation catheters in atrial fibrillation ablation: Data from a large prospective ablation registry.
J Cardiovasc Electrophysiol
November 2024
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Article Synopsis
- A study evaluated the safety of four new radiofrequency ablation catheters used for treating atrial fibrillation (AF), analyzing 3,957 procedures to identify outcomes and procedure times.
- The results showed that while most catheters achieved a 99.5% success rate in isolating pulmonary veins, differences emerged in procedure duration and complications, with QDOT Micro and THERMOCOOL SMARTTOUCH SF demonstrating shorter fluoroscopic times and lower rates of cardiac tamponade compared to TactiFlex and TactiCath.
- Findings suggest that the type of catheter and mapping system used impacts both safety outcomes and procedural efficiency in real-world applications, with TactiFlex exhibiting the highest risk for complications like cardiac tamponade.
The Feasibility, Safety and Outcome of Very High-Power Short Duration Radiofrequency Ablation in Pulmonary Vein Isolation: A Real-World Observation Study.
Rev Cardiovasc Med
July 2024
Department of Cardiology, University Hospitals of Leicester NHS Trust, LE1 5WW Leicester, UK.
Background: Pulmonary vein isolation (PVI) ablation is the established gold standard therapy for patients with symptomatic drug refractory atrial fibrillation (AF). Advancements in radiofrequency (RF) ablation, have led to the development of the novel contact force-sensing temperature-controlled very high-power short-duration (vHPSD) RF ablation. This setting delivers 90 W for up to 4 seconds with a constant irrigation flow rate of 8 mL/min.
View Article and Find Full Text PDFEvaluation of Ablation Parameters to Predict Irreversible Lesion Size During Pulsed Field Ablation.
Circ Arrhythm Electrophysiol
August 2024
Department of Cardiovascular Medicine, Cleveland Clinic, OH (H.N., M.S., A.A.H., S.N., P.S., W.I.S., O.M.W.).
Article Synopsis
- During pulsed field ablation (PFA), researchers studied the impact of various parameters like contact force (CF) and number of bursts on lesion size in beating hearts using a specialized catheter in swine.
- The study involved 11 closed-chest swine and tested different levels of CF and burst pulses, measuring lesion size after euthanization with a specific staining technique.
- Results showed that higher CF and more burst pulses significantly increased lesion depth, with a reliable formula predicting lesion size, while impedance decrease and electrode temperature were not effective predictors.
Background: The concept of ablation index (AI) was introduced to evaluate radiofrequency (RF) ablation lesions. It is calculated from power, contact force (CF), and RF duration. However, other factors may also affect the quality of ablation lesions.
View Article and Find Full Text PDFAtypical atrial flutter ablation: follow-up and predictors of arrhythmia recurrence.
Heart Vessels
November 2024
Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland.
Article Synopsis
- Advances in ablation techniques and 3D mapping systems have improved treatments, but many patients still experience atypical atrial flutter (AAFL) after pulmonary vein isolation (PVI).
- In a study of 45 patients, 60% experienced arrhythmia recurrence within a year, although over 70% reported feeling better. Prescription of class I antiarrhythmics was linked to lower recurrence rates, while cardioversion during the procedure increased recurrence risk.
- Overall, while symptom improvement is noted, the long-term success of AAFL ablation isn't encouraging, indicating a need for better strategies to maintain sinus rhythm post-procedure.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!