Abstract 13609: Racial Disparities and In-Hospital Outcomes of Atrial Fibrillation Ablations in Hypertrophic Cardiomyopathy: A 5-year Nationwide Inpatient Sample Analysis

Abstract

Introduction: Atrial fibrillation (AF) is a common supraventricular arrhythmia observed in patients with hypertrophic cardiomyopathy (HCM). However, there is a dearth of data regarding racial disparities and in-hospital outcomes specifically among HCM patients undergoing AF ablation. Methods: National Inpatient Sample database from 2016 to 2020 was queried for patients with HCM undergoing AF ablation using appropriate diagnostic and procedural ICD codes. These were further divided into African American (AA) and non-African American (non-AA) groups. Logistic regression was used to compare baseline characteristics and in-hospital outcomes. Results: A total of 610 HCM patients underwent AF ablation between 2016-2020. Out of these, 45 (7.4%) were AA. Compared to non-AA patients, AA patients undergoing AF ablation were younger (mean age: 61-vs-64 years), more often female (56%-vs-54%, p=0.28) and had a higher burden of comorbidities (Table 1). AA patients had lower length of stay (4.1-vs-4.7 days, p=0.008) and total hospital cost ($113,564-vs-158,904, p<0.001). The AA group had a higher prevalence of hypertension (44.4% -vs- 36.3%, p<0.001), obstructive sleep apnea (55.6% -vs- 21.2%, p<0.001), heart failure with reduced ejection fraction (22.2% -vs- 3.5%, p<0.001), alcohol use (11.1% -vs- 0.9%, p<0.001) and class I obesity (11.1% -vs- % 6.2%, p<0.001). This group also had higher in-hospital mortality (11.0% -vs- 0.9%, p<0.001) and worse in-hospital outcomes including acute pericarditis, cardiogenic shock, and requiring mechanical ventilation (Table 1). Conclusions: Despite lower length of stay and hospital cost, AA patients with HCM that underwent AF ablation had higher in-hospital mortality and complications compared to non-AA patients. These observed disparities warrant further research to gain a deeper understanding of the underlying factors contributing to these outcomes.