title: Trends and predictors of readmission after catheter ablation for atrial fibrillation, 2009-2013.
abstract: As the number of patients undergoing catheter ablation for atrial fibrillation (AF) increases, there is a growing focus on optimizing the quality and efficiency of. Readmission is often considered an indicator of both quality and efficiency of care delivery. We sought to estimate rates and identify predictors of readmission after catheter ablation.
  
  
  RESULTS
  Using a large, national administrative claims database, we identified all AF patients who underwent catheter ablation between January 2009 and December 2013 (10,705 ablation cases). We examined incident readmission and the primary diagnosis during the readmission episode of care. We used Cox proportional hazard models to identify associations between readmission and patient and institutional characteristics. A total of 1,433 (13.4%) ablation patients were readmitted within 90 days of ablation for any cause, and 573 (5.4%) were admitted with AF as the primary diagnosis. There was a decline in all-cause (from 15.6% to 12.8%; P = .04) and AF-related (6.4%-5.0 %; P = .03) 90-day readmission over the study period. In a multivariate model, earlier year of ablation and each of 9 chronic conditions (alone or in combination) were independently associated with risk of readmission.
  
  
  CONCLUSIONS
  Between 2009 and 2013, there was a reduction in 90-day readmission rates after AF ablation, suggesting improved periprocedural care of these patients. Identifying patients at high risk for readmission after catheter ablation for AF may offer an opportunity for early intervention and, ultimately, reduction in procedural morbidity and medical costs.
authors.affiliation: Heart Rhythm Section, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN. Electronic address: noseworthy.peter@mayo.edu.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Noseworthy
authors.affiliation: Heart Rhythm Section, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Suraj
authors.initials: S
authors.lastname: Kapa
authors.affiliation: Mayo Clinic Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Rochester, MN.
authors.forename: Lindsey R
authors.initials: LR
authors.lastname: Haas
authors.affiliation: Mayo Clinic Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Rochester, MN.
authors.forename: Holly
authors.initials: H
authors.lastname: Van Houten
authors.affiliation: Heart Rhythm Section, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Abhishek J
authors.initials: AJ
authors.lastname: Deshmuk
authors.affiliation: Heart Rhythm Section, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Siva K
authors.initials: SK
authors.lastname: Mulpuru
authors.affiliation: Heart Rhythm Section, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: McLeod
authors.affiliation: Heart Rhythm Section, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Asirvatham
authors.affiliation: Heart Rhythm Section, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Friedman
authors.affiliation: Mayo Clinic Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Rochester, MN; Optum Labs, Cambridge, MA.
authors.forename: Nilay D
authors.initials: ND
authors.lastname: Shah
authors.affiliation: Heart Rhythm Section, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Packer
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000639:trends*; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome