Atrial Fibrillation and the Risk of Heart Failure
CBSMD

June, 2018 "Progression of Device-Detected Subclinical Atrial Fibrillation and the Risk of Heart Failure" pointed out patients with a pacemaker or defibrillator, short-lasting, subclinical atrial fibrillation (SCAF) progression was strongly associated with HF hospitalization.

In a nationally representative cohort, US National Readmissions Database, which collects data from 22 states. There were 60,203 adults who underwent CA of AF. The primary endpoint was early mortality, defined as mortality either during the index ablation hospitalization or during 30-day rehospitalizations. Early mortality following AF ablation affected nearly 1 in 200 patients, with the majority of deaths occurring during 30-day readmission. Procedural complications, congestive heart failure, and low hospital AF ablation volume were predictors of early mortality. Prompt management of post-procedure complications and CHF may be critical for reducing mortality rates following AF ablation. The mortality rate reported in this study is likely to be an underestimate, because deaths that occurred outside the hospital or in a state other than the one in which the index ablation procedure was performed were not accounted for in the National Readmissions Database. In addition to early identification and treatment of a complication and HF, the data suggest that mortality also could be improved by restricting low-volume hospitals from performing AF CA procedures in the absence of an experienced proctor.

1. Screening for Atrial Fibrillation With ECG: USPSTF Recommendation

2. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society