Safety of Catheter Ablation for Atrial Fibrillation in Patients with
Liver Cirrhosis
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