Differences in outcomes among patients with atrial fibrillation undergoing catheter ablation with versus without intracardiac echocardiography

Abstract

Background: Intracardiac echocardiography (ICE) use can lead to early detection of periprocedural complications and may improve patient outcomes by providing real-time visualization of catheter location and the treatment area during cardiac ablation (CA) for atrial fibrillation (AF). Objective: Examine complications and 12-month healthcare use among patients with AF undergoing CA with versus without ICE use during the procedure in a real-world setting. Methods: The 2015–2020 IBM MarketScan® Database was used to identify non-elderly adults (age 18–64 years) undergoing CA for AF. Patients were classified into ICE/non-ICE groups based on the presence or absence of ICE procedure codes. Patients in each group were matched on study covariates using propensity scores. Peri-procedural complications, 12-month cardiovascular (CV) or AF-related inpatient admission, repeat CA, and cardioversion were compared using a Cox proportional hazard model. Results: 1371 patients were identified in each study cohort (ICE and non-ICE) after propensity matching. Patients who had CA with ICE had a significantly lower rate of complications than those without (2.9% vs. 5.8%; p