Introduction: Catheter ablation procedures are utilized for rhythm control of atrial fibrillation (AF) but the utilization of this procedure based on race remains uncertain. Purpose: We investigated trends in admissions due to AF and utilization of AF ablation, based on race.
Methods: The 2000-2013 National Inpatient Sample (NIS) from Healthcare Utilization Project (HCUP) was analyzed for hospitalizations in patients with known history of AF based on ICD-9-CM codes. Observations with unknown or missing race were excluded.
Results: 35,761,659 adults (mean age 75.9 ± 11.8) with known AF were hospitalized (49.0% males and 51.0% females). AF was the primary reason for admission in 4,158,058 (11.6%) patients that consisted of 86% whites, 7% Blacks, 5.3% Hispanics, 1.4% Asians and 0.3% Native Americans. Of these patients admitted primarily for AF, ablation procedures were performed in 96,250 (2.31%) patients. The proportion who underwent ablation during an admission for AF, was lowest among blacks (whites 2.46%; blacks 1.11%; Hispanics 1.5%, Asians 2.15% and Native Americans 3.25%). There is a rising trend of ablation procedures among patients admitted due to AF: 0.5% in the year 2000 to 2.82% in 2013 (p trend < 0.001). The difference in the proportion of black vs. non-black patients having ablation has increased from 0.43% in the year 2000 to 1.42% in the year 2013. On multivariable analysis, adjusting for relevant patient-related factors, the likelihood of black patients being hospitalized primarily for AF was higher than non-blacks (OR: 1.04, p < 0.001). However, adjusting for the same patient-related factors, the likelihood of black patients undergoing ablation, during admission for AF remained lower than non-blacks (OR: 0.51, p < 0.001).
Conclusion: For patients hospitalized due to AF, ablation of AF is being increasingly utilized. Black patients are more likely to get hospitalized due to AF but less likely to undergo ablation than non-black patients.