(BSPOT09) Hospital readmissions among patients with atrial fibrillation undergoing catheter ablation using ThermoCool SmartTouch/ThermoCool SmartTouch SF Catheter with CARTO 3 System versus TactiCath Catheter with EnSite System

Background: Radiofrequency (RF) ablation is a mainstay of catheter ablation (CA) treatment for atrial fibrillation (AF). RF ablation catheters with contact force (CF) sensing techniques paired with electroanatomical mapping systems (EAMs) allow for real-time assessment of the contact force applied at the catheter tip-tissue interface.

Objectives: The objective of this study was to examine the differences in inpatient readmissions among AF patients treated with ThermoCool SmartTouch® (ST)/ThermoCool SmartTouch® SF (STSF) Catheter with CARTO® 3 System versus TactiCath™ Catheter with EnSiteTM System during catheter ablation procedures.

Methods: Using the 2018–2022 Premier Healthcare Database® (PHD), a United States (US)-nationwide multi-hospital billing database, AF patients aged ≥18 years undergoing catheter ablation procedure were identified. Patients were classified into two cohorts based on the catheter used during the ablation procedure: ST/STSF or TactiCath™. Study outcomes assessed included all-cause, cardiovascular-related and AF-related inpatient readmissions during the 91-365-day post CA period. Inverse probability of treatment weighting (IPTW) was used to balance patient demographic characteristics, comorbidity and hospital characteristics between the two cohorts. A weighted generalized estimating equation (GEE) model was used to examine differential in readmission outcomes.

Results: A total of 13,001 CARTO® 3 patients and 2,517 EnSiteTM patients were identified based on the study criteria. After IPTW, patient characteristics were well balanced between the two cohorts, however, hospital bed size, hospital region and ablation volume were further controlled in the GEE models. Patients using ST/STSF Catheter with CARTO® 3 System had significantly lower rate of 91-365-day all-cause inpatient readmissions as compared to those treated with TactiCath™ Catheter with EnSiteTM System (7.8% vs 9.3%, p=0.041). Results from GEE analysis revealed that patients treated with ST/STSF had 20% lower likelihood of all-cause inpatient readmissions (Odds ratio [OR] 0.80, 95% confidence interval [CI] 0.66-0.96, p=0.019) and 21% lower likelihood of cardiovascular-related inpatient readmission (5.2% vs. 6.2%, p=0.133; OR 0.79, 95% CI 0.62-0.99, p=0.043) in 91-365 days post CA as compared to those treated with TactiCath™ catheter. No significant differences were observed for the AF-related readmission.

Conclusions: Among patients undergoing CA for AF, those treated with the ST/STSF Catheter with CARTO® 3 System had significantly lower risk of all-cause and cardiovascular-related inpatient readmissions compared to those treated with TactiCath™ Catheter with EnSiteTM System.