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Safety of Catheter Ablation for Atrial Fibrillation in Patients with Liver Cirrhosis
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  • Nelson Barrera,
  • Katerina Jou,
  • Mushrin Malik,
  • Francisco Gallegos-Koyner,
  • Salomon Chamay,
  • Khaled Elfert,
  • Roberto Cerrud-Rodriguez,
  • Luigi Di Biase
Nelson Barrera
Montefiore Einstein Center for Heart and Vascular Care

Corresponding Author:[email protected]

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Katerina Jou
St Barnabas Hospital
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Mushrin Malik
St Barnabas Hospital
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Francisco Gallegos-Koyner
St Barnabas Hospital
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Salomon Chamay
St Barnabas Hospital
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Khaled Elfert
St Barnabas Hospital
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Roberto Cerrud-Rodriguez
Yale New Haven Hospital Heart and Vascular Center
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Luigi Di Biase
Montefiore Einstein Center for Heart and Vascular Care
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Abstract

Background and Aims Atrial fibrillation is the most prevalent cardiac arrhythmia, and catheter ablation (CA) has emerged as a viable option for selected patients. However, its role in specific liver cirrhosis (LC) populations remains underexplored. Methods Using the National Inpatient Sample Database 2016–2020, we analyzed adult encounters undergoing CA for atrial fibrillation diagnosed with LC. Using propensity scores, encounters were divided into 2 cohorts based on the presence and absence of LC and matched in a 1:1 fashion using LC as the dependent variable. In-hospital mortality and post-procedure total complications were compared using logistic regression models and linear regression for length of stay and total cost of hospitalization. Results We identified 93,830 atrial fibrillation CA admissions, of which 910 had LC. The mean age in the LC cohort was 66.5±5.1 years. Mortality did not significantly differ between the groups (aOR=0.85; 95%CI=0.28-2.60; P=0.77). However, the LC cohort exhibited higher odds of total complications (aOR=2.00; 95%CI=1.11-3.48; p<0.01). Length of stay was comparable, but total cost showed statistically significant differences among the two cohorts: 6.7 days (95%CI=6.8-7.46; P<0.0001) vs. 6.3 days (95%CI=5.4-7.2;p<0.0001) and $184,000 (95%CI=$169 000-$201 000; P<0.0001) vs. $193,000 (95%CI=$171 000-$216 000;p<0.0001), respectively. Conclusion In the 2016-2020 National Inpatient Sample, patients who underwent atrial fibrillation CA with LC, mortality, and length of stay were comparable. However, the likelihood of total complications was higher to a propensity score‐matched cohort of no cirrhotics patients. Further, longitudinal studies are needed it to assess the safety profile of CA in this sub-population
13 May 2024Submitted to Journal of Cardiovascular Electrophysiology
15 May 2024Reviewer(s) Assigned
04 Jun 2024Review(s) Completed, Editorial Evaluation Pending
06 Jun 2024Editorial Decision: Revise Minor