Abstract
Background We sought to assess the impact of ablation during index hospitalization (IH) on all-cause
mortality (ACM) in patients presenting with newly diagnosed typical atrial flutter
(tAFL) as compared with patients without ablation, irrespective of optimal rate or
rhythm control medications.
Methods We identified patients with newly diagnosed tAFL in the TriNetX Research Network
between January 20, 2010, and January 20, 2021. Using International Classification
of Diseases, 10th revision (ICD-10) codes, patients were stratified into those who
had undergone ablation during IH and those who did not undergo the procedure. Results
were assessed using propensity score matching (PSM) analysis as well as Kaplan–Meier
curves.
Results A total of 12,986 (N) patients (aged 35–85 years) met our inclusion criteria. Of
those, 3,665 had undergone ablation during IH compared with 9,321 patients who did
not. Patients in the ablation group (mean age 64.3 ± 10.1 years) had a higher prevalence
of hypertension (80 vs. 78.3%, p = 0.02), respectively. PSM created two well-matched groups of 3,652/3,652 patients
each with an ACM of ablation of 4.5 versus 7.8% (p = 0.01) at 6 months, 6.6 versus 11.4% (p = 0.01) at 12 months, and 14.5 versus 20.9% (p < 0.001) at 36 months of follow-up. Survival data were confirmed through Kaplan–Meier
analysis using a log-rank test.
Conclusion From a large, federated, multicenter population database, we report significant survival
benefit of ablation during IH in patients presenting with new tAFL diagnosis. Kaplan–Meier
mortality curves confirmed survival advantage with ablation at 6, 12, and 36 months
of follow-up in this cohort.
Keywords ablation - all-cause mortality - typical atrial flutter - cardiovascular mortality
