Costea Alexandru I, Khanna Rahul, Iglesias Maximiliano, Rong Yiran
The Christ Hospital Cincinnati, Cincinnati, OH, USA.
MedTech Epidemiology & Real-World Data Science, Johnson & Johnson, New Brunswick, NJ, USA.
J Comp Eff Res. 2025 Jan;14(1):e240075. doi: 10.57264/cer-2024-0075. Epub 2024 Dec 4.
Radiofrequency (RF) catheter ablation (CA) is a mainstay treatment for atrial fibrillation (AF). RF catheters with contact force (CF) sensing technology and electroanatomical mapping systems enable real-time assessment of catheter tip-tissue interface CF, facilitating individualized and precise CA. This study examined inpatient hospital readmissions in patients with AF treated with THERMOCOOL™ ST/ THERMOCOOL™ STSF catheter with the CARTO™ 3 System versus TactiCath™ catheter with the EnSite™ System. Patients undergoing CA for AF between 1 July 2019 to 30 November 2021 were identified from the Premier Healthcare Database and grouped based on use of THERMOCOOL ST/STSF or TactiCath™. Study outcomes were all-cause, cardiovascular (CV)-, and AF-related inpatient readmission at 91-365-day post-CA. Inverse probability of treatment weighting of propensity scores balanced baseline patient, comorbidity and hospital characteristics. A weighted generalized estimating equation (GEE) model examined differences in readmission outcomes. A total of 15,518 patients met inclusion criteria (THERMOCOOL ST/STSF, n = 13,001; TactiCath™, n = 2517). Patient characteristics were generally well-balanced after weighting. Patients treated with THERMOCOOL ST/STSF + CARTO 3 had a 20% lower likelihood of all-cause inpatient readmissions (7.8 vs 9.3%, chi-square p = 0.041; odds ratio [OR]: 0.80, 95% confidence interval [CI]: 0.66-0.96, GEE p = 0.019) and a 21% lower likelihood of CV-related inpatient readmission (5.2 vs 6.2%, chi-square p = 0.133, OR: 0.79, 95% CI: 0.62-0.99, GEE p = 0.043) in 91-365-days post-CA versus those treated with TactiCath™ + Ensite. No significant differences were observed for AF-related readmissions. Patients undergoing CA for AF treated with THERMOCOOL ST/STSF + CARTO 3 had a significantly lower risk of all-cause and CV-related inpatient hospital readmission versus those treated with TactiCath™ + Ensite.
射频(RF)导管消融术(CA)是心房颤动(AF)的主要治疗方法。具有接触力(CF)传感技术的射频导管和电解剖标测系统能够实时评估导管尖端与组织界面的接触力,有助于实现个体化和精确的导管消融。本研究比较了使用THERMOCOOL™ ST/THERMOCOOL™ STSF导管与CARTO™ 3系统治疗的房颤患者和使用TactiCath™导管与EnSite™系统治疗的房颤患者的住院再入院情况。从Premier医疗数据库中识别出2019年7月1日至2021年11月30日期间接受房颤导管消融治疗的患者,并根据是否使用THERMOCOOL ST/STSF或TactiCath™进行分组。研究结局为导管消融术后91至365天的全因、心血管(CV)和房颤相关的住院再入院情况。倾向评分的逆概率治疗加权平衡了基线患者、合并症和医院特征。加权广义估计方程(GEE)模型检验了再入院结局的差异。共有15518例患者符合纳入标准(THERMOCOOL ST/STSF组,n = 13001;TactiCath™组,n = 2517)。加权后患者特征总体平衡。与使用TactiCath™ + Ensite系统治疗的患者相比,使用THERMOCOOL ST/STSF + CARTO 3系统治疗的患者在导管消融术后91至365天内全因住院再入院的可能性降低了20%(7.8%对9.3%,卡方检验p = 0.041;优势比[OR]:0.80,95%置信区间[CI]:0.66 - 0.96,GEE检验p = 0.019),CV相关住院再入院的可能性降低了21%(5.2%对6.2%,卡方检验p = 0.133,OR:0.79,95% CI:0.62 - 0.99,GEE检验p = 0.043)。房颤相关再入院情况未观察到显著差异。与使用TactiCath™ + Ensite系统治疗的患者相比,使用THERMOCOOL ST/STSF + CARTO 3系统治疗的房颤导管消融患者全因和CV相关住院再入院风险显著更低。