Abstract 15469: The Efficacy and Safety of Atrial Fibrillation Ablation in the VA Healthcare System

IntroductionAtrial fibrillation (AF) is associated with adverse outcomes such as increased healthcare costs, impaired quality of life (QOL), stroke and mortality. Catheter ablation of AF plays an important role in management and is associated with improvement in QOL and improved left ventricular function in heart failure. But the procedure is associated with several complications and a redo ablation is needed in a proportion of patients.MethodsWe identified all patients who underwent AF ablation in the VA healthcare system from January 2013 to January 2017 (diagnosis code 427.31 and procedure code 37.34) and evaluated the efficacy and safety outcomes of AF ablation.Results1069 ablations were performed in 921 patients at 34 VA hospitals. Patient characteristics were as followsmales 97.3%, mean age 63.88 ± 7.99 years, mean CHA2DS2VASc score 2.33 ± 1.55, hypertension 42.75%, diabetes 40.51%, heart failure 40.51%, prior stroke 20.49%, smoking history 35.73%, chronic obstructive pulmonary disease 34.24%, sleep apnea 45.65%, and mean body mass index 32.4 ± 6.1 kg/m. Mean follow-up duration was 36.8 ± 13.9 months. Procedure efficacy and safety outcomes are detailed in the table. Mortality rate at 1 month was 0.47%. Redo ablation procedure was done in 16.65% during the follow-up period and 66.32% were off anti-arrhythmic medications.ConclusionsAF ablation has a reasonable safety profile in the VA population. It is effective, and about two-thirds of the patients were off anti-arrhythmic medications at the time of follow-up after the procedure.