Initial Findings From the National Cardiovascular Data Registry of Atrial Fibrillation Ablation Procedures

BACKGROUND The National Cardiovascular Data Registry (NCDR) AFib Ablation Registry was created to assess real-world prevalence, demographic characteristics, procedural management, and outcomes of patients under -going atrial fibrillation (AF) ablation procedures.OBJECTIVES The goal of this study was to characterize the patient, hospital, and physician characteristics and in-hospital outcomes related to AF ablation in the first 5 years of the registry.METHODS This paper describes the AFib Ablation Registry structure and governance, outcome assessment processes, data quality, and data collection processes. The characteristics of the patient population, hospitals, and in-hospital outcomes are also described. RESULTS A total of 76,219 patients were included in the registry between January 2016 and December 2020 (mean age 65.5 +/- 10.3 years, 65.2% male, 55.8% paroxysmal AF, mean CHA2DS2-VASc score 2.7 +/- 1.6) treated by 708 physicians in 162 hospitals. Successful isolation of all pulmonary veins was achieved in 92.4% of patients. The prevalence of any complication during procedural admission was 2.50% and major complication was 0.9%, including significant bradycardia in 0.47%, heart failure in 0.47%, and pericardial effusion requiring intervention in 0.44%. Hospitalization >1 day occurred in 11.8% of patients, and in-hospital death was rare (n = 41 [0.05%]).CONCLUSIONS The NCDR AFib Ablation Registry is the largest multicenter, prospective cohort study of patients undergoing catheter ablation worldwide. Results in the first 5 years showed that successful pulmonary vein isolation is achieved in the majority of patients, with a low rate of complications. Future studies from the registry will assess practice trends, evaluate treatment patterns associated with different patient outcomes, and support develop-ment of evidence-based guidelines. (J Am Coll Cardiol 2023;81:867-878)(c) 2023 by the American College of Cardiology Foundation.

Automated summary

The National Cardiovascular Data Registry (NCDR) AFib Ablation Registry was created to evaluate real-world prevalence, demographic characteristics, procedural management, and outcomes of atrial fibrillation (AF) ablation procedures. This study describes the characteristics of patients, hospitals, and in-hospital outcomes related to AF ablation in the first 5 years of the registry. The results show a high success rate of pulmonary vein isolation and a low rate of complications during hospitalization.