2-047 Predictors of major adverse cardiac and cerebrovascular events in patients undergoing non elective catheter ablation for atrial fibrillation

<h3>Background</h3> The use of cardiac ablation among patients with cardiac arrhythmias is becoming increasingly pivotal in the management of atrial fibrillation. Major adverse cardiac and cerebrovascular events(MACCE) can occur following such procedures and it is vital to identify at-risk groups. We aimed to evaluate incidence of MACCE among patients undergoing cardiac ablation for atrial fibrillation, as well as factors that may influence such events. <h3>Methods</h3> Patients undergoing non-elective catheter ablation between 2016 and 2021 were studied from the National Inpatient Sample. We excluded patients with other forms of dysrhythmias and procedures which may have impacted events of MACCE as advised in prior studies. Multivariable logistic regression models were created to identify the independent factors that influenced events of MACCE. <h3>Results</h3> A total of 12285 adult patients underwent non-elective cardiac ablation, with a mean age of 66.0 years. Of these, 4.4% reported events of MACCE. Their mean age was 68.69 years (vs. 65.84, p&lt;0.01). In our cohort, events of MACCE were more likely to involve patients who were admitted on weekend (aOR 1.575, CI 95% 1.263–1.965, p&lt;0.001), Black(aOR 1.382, CI 95% 1.024–1.866, p=0.034, vs. White), had underlying chronic kidney disease(CKD) (aOR 2.024, 95% CI 1.64–2.498, p&lt;0.001), congestive heart failure(CHF) (aOR 1.665, 95% CI 1.349–2.055, p&lt;0.001), and coagulopathy (aOR 1.603, 95% CI 1.178–2.183, p=0.003). Lower odds were noted among smokers (aOR 0.576, 95% CI 0.466–0.712, p&lt; 0.001) and obese patients (aOR 0.74, 95% CI 0.589–0.929, p=0.01). Our study found no sex based differences (Females aOR 0.882, 95% CI 0.726–1.071, p=0.204 vs. Males), nor disparities based on insurance form (Medicaid aOR 1.173, 95% CI 0.784–1.755, p=0.437, Private aOR 1.198, 95% CI 0.919–1.562, p=0.182 vs. Medicare) and teaching status of the hospitals (Urban non teaching aOR 1.042, 95% CI 0.511–2.121, p=0.911, Urban teaching aOR 0.549, 95% CI 0.276–1.091, p=0.087). Other comorbidities that did not report statistical significance for MACCE include diabetes (aOR 0.92, 95% CI 0.744–1.138, p=0.442), dyslipidemia (aOR 0.872, 95% CI 0.721–1.055, p=0.158), prior myocardial infarction (aOR 0.76, 95% CI 0.527–1.096, p=0.141), hypertension (aOR 1.176, 95% CI 0.907–1.524, p=0.22), frailty (aOR 1.226, 95% CI 0.907–1.658, p=0.185), peripheral vascular disease (aOR 0.941, 95% CI 0.667–1.328, p=0.731), and valvular disease (aOR 0.907, 95% CI 0.72–1.143, p=0.41). Events of MACCE led to a lengthier stay (mean stay of 8.63 days vs. 4.11 days, p&lt;0.01), with a higher inflation-adjusted hospital cost ($45565 vs. $33812, p&lt;0.01). <h3>Conclusion</h3> The incidence of MACCE was 4.4% among patients undergoing non-elective cardiac ablation for atrial fibrillation, which can be impacted by race and pre-existing comorbidities such as CKD, CHF, and coagulopathy. Further prospective studies are warranted to bridge the gaps in healthcare based on race, and to screen and monitor patients with such comorbidities.