Abstract 12324: Current Trends in Anticoagulation, Referral and Utilization of Procedures for Rhythm Control for Atrial Fibrillation

Abstract

Introduction: Atrial fibrillation (AF) can reduce quality of life and cause thromboembolic events, heart failure and death. Prior studies have identified disparities in the treatment of AF based on sex, race, and ethnicity. Hypothesis: There will be disparities in procedures for rhythm control (RC) based on sex, race and ethnicity. Methods: Cohorts of patients with new AF from 2016 to 2021 were identified with 1 year follow up to identify referrals, anticoagulant prescription, and procedures for RC. We calculated the proportion of patients with each outcome overall stratified by sex and race/ethnicity. We used logistic regression to compare outcomes across sex and race/ethnicity after adjustment for confounding variables. Results: We identified 2,919 patients with a new onset AF. The mean age: 68 years, 53% were male, 66% had Medicare, 69% self-identified as White, 23% as Black, and 3% as Hispanic. There was no difference in referral rates between men and women. Compared to White patients, Black and Hispanic patients were more likely to be referred to Cardiology and more likely to complete a visit. Prescription of anticoagulants was high (83%) and did not differ between men and women (84% vs. 82%, p = 0.65). Compared to White patients, Black and Hispanic patients were more likely to receive a prescription for anticoagulation (86% and 88% vs. 81%, p = 0.006). Women were significantly less likely to receive cardioversion or ablation compared to men (17% vs. 25%, p < 0.001). Similarly, Blacks and Hispanics were significantly less likely to receive procedures compared to Whites (17% vs. 23%, p = 0.01). Conclusions: Despite equal attendance at Cardiology visits, women and Black or Hispanic patients were significantly less likely to receive cardioversion or ablation compared to men and Whites respectively.