Abstract 10321: Safety of Catheter Ablation Therapy for Atrial Fibrillation in Cardiac Amyloidosis

Abstract

Introduction: Despite a high burden of atrial fibrillation (AF) in cardiac amyloidosis (CA), the safety of catheter ablation therapy (CAT) in CA is not well established. We sought to examine short-term safety outcomes following CAT for AF in patients with CA compared to matched patients with dilated cardiomyopathy (DCM). Methods: Using data from National Inpatient Sample (NIS), we identified all hospitalizations for AF CAT from the fourth quarter of 2015 through 2019. We matched CA to DCM admissions in a 1:5 ratio using propensity scores based on sociodemographic, clinical comorbidities, and hospital characteristics. We compared in-hospital outcomes including mortality, procedural complications, discharge disposition, total charges, and length-of-stay Results: Overall, 1,395 unweighted hospitalizations (representing 6,750 national hospitalizations) for AF CAT were included in analysis, out of which 45 (3.2%) were admissions for CA. Compared to DCM, CA patients were older (72.9years vs 65.1years), had a higher burden of prior stroke (20.0% vs 8.6%) and chronic kidney disease (53.3% vs 33.6%), and were less likely to have a prior ICDs (4.4% vs 23.0%). We matched 42 amyloid hospitalizations to 210 DCM hospitalizations. After matching, there was no difference in rate of in-hospital mortality (0.24 vs 0.33%, p=0.77), home disposition (97.6% vs 96.2%, p=0.65), total procedural complications (14.3% vs 10.5%, p=0.60), length-of-stay (3.1 days vs 2.1 days, p = 0.23) and total hospital charges ($137,250 vs $133,910, p=0.24). Conclusions: In this contemporary study of CAT for AF in CA, short-term safety outcomes and complication rates were similar to a propensity-score-matched cohort of DCM. Further studies exploring long-term safety outcomes are needed.