Efficacy and Safety Outcomes of Catheter Ablation of Non-valvular Atrial Fibrillation in Korean Practice: Analysis of Nationwide Claims Data

ABSTRACT

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the effectiveness and selected adverse events of radiofrequency catheter ablation in patients treated for drug-refractory atrial fibrillation (AF) using claims data provided by the Health Insurance Review and Assessment Service, which covers all ablation procedures conducted in South Korea. SUBJECTS AND METHODS: The study population included patients who underwent catheter ablation for AF between January 2011 and December 2013. A total of 3,850 patients without a previous history of catheter ablation procedure were enrolled. We analyzed 2-year effectiveness of the index ablation. Any redo ablation, electrical cardioversion, or use of antiarrhythmic drug beyond the blanking period of 3 months was considered a failure of index ablation. RESULTS: Overall recurrence rate following AF ablation was 61.1%. The recurrence rate was lower in patients under 65 years old than in those over 65 years old (hazard ratio [HR] 0.89; 95% confidence interval [CI], 0.81 to 0.97, P=0.009). Repeat ablation was more frequent in men (HR 1.56; 95% CI, 1.20 to 2.04; P=0.001) and patients under 65 years old (HR 1.79; 95% CI, 1.34 to 2.38; P < 0.001). Electric cardioversion was more frequent in men (HR 1.35; 95% CI, 1.06 to 1.72; P=0.014) than in women. The overall rate of stroke, blood transfusion, significant pericardial complication, and cardiopulmonary resuscitation was 0.5%, 4.8%, 2.7%, and 0.2%, respectively. CONCLUSIONS: In the present study, old age was associated with treatment failure of catheter ablation for drug-refractory AF in the Korean population. Overall recurrence did not vary with respect to sex.