title: Risk predictors of stroke and mortality after ablation for atrial fibrillation: the California experience 2005-2009.
abstract: BACKGROUND
  Ablation (ABL) is a second-line therapy for the management of atrial fibrillation (AF). Single-center studies have demonstrated the safety and efficacy of ABL; however, the low event rates render it difficult to assess predictors of major adverse events.
  
  
  OBJECTIVE
  The purpose of this study was to determine the population-based incidence of data and risk factors for both stroke <30 days and death after AF ABL.
  
  
  METHODS
  Patients (n = 6207) identified as having undergone AF ABL between 2005 and 2009 by the California Ambulatory Surgery Database in 97 nonfederal hospitals in California were linked to the California Patient Discharge Database and to a master death registry. Data from these patients were analyzed for primary outcomes of 30-day death and ischemic stroke. Independent risk factors for these end-points were determined.
  
  
  RESULTS
  Mean patient age was 61.9 years, and the majority of the patients were men. Thirty-day mortality and stroke after ABL were 0.39% and 0.61%, respectively. Independent predictors of death were age ≥80 years (odds ratio [OR] 8.2, 95% confidence interval [CI] 1.5-43) and heart failure (OR 9.2, 95% CI 3.0-28). Prior stroke/transient ischemic attack/stroke was the only independent predictor for stroke (OR 6.3, 95% CI 3-13).
  
  
  CONCLUSIONS
  In our large population-based study, we found higher procedure-related mortality but comparable stroke rate after AF ABL than previously reported. Age ≥80 years and heart failure was each independently associated with >8-fold increase in odds of death. The only significant predictor of stroke was prior stroke/transient ischemic attack. These findings may aid in patient selection for AF ABL.
authors.affiliation: Division of Cardiovascular Medicine. Electronic address: uma.srivatsa@ucdmc.ucdavis.edu.
authors.forename: Uma N
authors.initials: UN
authors.lastname: Srivatsa
authors.affiliation: Department of Internal Medicine, UC Davis School of Medicine, Sacramento, California.
authors.forename: Beate
authors.initials: B
authors.lastname: Danielsen
authors.affiliation: Division of Cardiovascular Medicine.
authors.forename: Ivan
authors.initials: I
authors.lastname: Anderson
authors.affiliation: Division of Cardiovascular Medicine.
authors.forename: Ezra
authors.initials: E
authors.lastname: Amsterdam
authors.affiliation: Division of Cardiovascular Medicine.
authors.forename: Nayereh
authors.initials: N
authors.lastname: Pezeshkian
authors.affiliation: Division of Cardiovascular Medicine.
authors.forename: Yingbo
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Internal Medicine, UC Davis School of Medicine, Sacramento, California.
authors.forename: Richard H
authors.initials: RH
authors.lastname: White
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000401:mortality* / Q000601:surgery*; D002140:California / Q000453:epidemiology; D017115:Catheter Ablation; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000401:mortality*
keywords: Ablation; Atrial fibrillation; Mortality; Stroke