Racial Disparities in Atrial Fibrillation Treatment: A Closer Look at Repeat Ablation Outcomes

Racial Disparities in Atrial Fibrillation Treatment: A Closer Look at Repeat Ablation Outcomes | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Racial Disparities in Atrial Fibrillation Treatment: A Closer Look at Repeat Ablation Outcomes Juzer Ali Asgar, Aadavan Elangovan, Leonard Efuet-Ateh, Angelina Isaac, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9111318/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Introduction: Atrial Fibrillation (AF) is the most prevalent chronic cardiac arrhythmia in adults, often leading to higher risk for further significant cardiac comorbidities. Atrial fibrillation is a disease with known disparities across racial groups, but repeat ablation outcomes are not well characterized currently. Objective: We aimed to retrospectively evaluate whether race was associated with discrete differences with repeat AF Ablation within 3 years after an index ablation, while also examining age- and gender- based differences. Method: We performed a multicenter retrospective cohort study with a population of adults over the age of 18, with AF Ablation between 1/1/2018, and 6/30/2020. We had over 23,558 encounters after excluding encounters that didn't belong within our parameters. Our primary outcome was to evaluate repeat ablation and readmission data with atrial fibrillation within 3 years. We elucidated statistics using chi-square plus multivariable adjusted analysis for age and sex based demographics, with pairwise racial subgroup comparisons. Results: The overall repeat ablation rate was 14.3% (N = 3368/23558). In the overall racial comparison, race was not significantly associated with repeat ablation rates (chi-square = 7.875, p = 0.1633; likelihood ratio = 8.3235, p = .1393). We also saw little statistical significance of white versus non-white patients, (chi-square = 2.1400, p = 0.1435). Pairwise subgroup comparisons did not demonstrate significant differences after multiple-comparison adjustment. In adjusted analyses, sex was not significantly associated with repeat ablation (p = 0.1611), whereas patients younger than 80 years had higher odds of repeat ablation compared with those aged 80 years and older, including ages 50–59 (OR 1.423), 60–69 (OR 1.433), 70–79 (OR 1.307), and < 50 (OR 1.344). Conclusion: In this multicenter retrospective cohort, race did not show an independent association with repeat AF ablation within 3 years of index ablation. However, these findings do not interpret itself as evidence of AF burden or treatment experience to be equivalent amongst racial groups. Furthermore, age-related differences in repeat ablation suggest that treatment prognostication varies amongst patient subgroups warranting further study in larger datasets. Figures Figure 1 Introduction Atrial fibrillation (AF), the most prevalent chronic cardiac arrhythmia in adults, significantly increases the risk of stroke, cardiac ischemia, and heart failure. 1 AF causes a loss of synchronized atrial contractions, decreasing stroke volume (SV) and thus cardiac output (CO). Left atrial (LA) function involves three integrated phases: reservoir, conduit, and booster-pump (contractile). Impairment of any phase, especially the contractile phase, reduces CO by up to 20%. 2 This hemodynamic deficit is poorly compensated, leading to elevated LA and right atrial (RA) pressures, which predispose the atrial myocardium to dilation and AF propagation. 3 Previous studies have examined racial differences in comorbidities and AF risk. The CARDIA study, a prospective cohort of young Black and White adults (ages 18–30, 1985–1986), found that Black individuals had higher SBP, were more often on antihypertensives, smoked more, and had greater LV mass. However, after adjusting for demographics and comorbidities, White individuals had a larger left atrial diameter (LAD) than Black individuals (unadjusted LAD was the opposite). 4 Similar racial LAD differences were noted in individuals over 65 with high CVD burden (The Cardiovascular Health Study and the Heart and Soul Study), where Whites had an approximate 2 mm larger LAD. A 5mm larger LAD is linked to a 40% higher AF risk. 5 – 6 Despite this and similar comorbidities observed in studies like Framingham and MESA, a racial paradox exists: Blacks have a lower incidence of AF than Whites. 7 Racial differences in AF risk necessitate examining management strategies, particularly ablation versus antiarrhythmic drugs (ADT). The APAF trial showed circumferential pulmonary vein ablation (CPVA) was superior to ADT for maintaining sinus rhythm in selected patients, though it didn't assess race. 8 Radiofrequency ablation (RFA) improves cardiac output by achieving sinus rhythm and aiding left atrial remodeling. However, data is scarce on whether ablation strategies are utilized or effective differently across demographics. Addressing this critical gap, we will study disparities in AF recurrence requiring repeat ablations across gender, age, and race. Method This multi-center retrospective cohort study looked at all encounters for adults (18+) who had an ablation procedure for AF between 1/1/2018-06/30/2020 at a multi-center hospital group.. Then within these encounters, the ones readmitted over the course of 3 years with AF/AFL were isolated. Initial encounters were 25,315, 54 removed due to unknown sex. The remaining 25,261 were further evaluated, 228 removed as they did not have AF, and 1475 duplicated encounters. The remaining encounters were 23,558 that included patients with history of index AF ablation who were readmitted for AF or other diagnoses, found to have recurrence of AF within a 3-year period. Chi-square and multivariate adjusted analyses were conducted to assess statistical significance amongst various ethnic groups. Results The initial clinical hypothesis regarding racial disparity is that the patient’s race is associated with a difference in repeat AF ablation within 3 years of the initial hospital encounter. The race of patients was divided into White, Asian, African American, Multi-ethnicity or other, Hispanic, and Native-American. We performed multiple pairwise comparisons to evaluate any statistical difference between Whites and all other racial/ethnic groups. The total re-ablation rate for AF in readmission within 3 years was 14.3% (N = 3368/23558). Using a chi-square test to compare the rate of AF re-ablation to those who didn’t, the result was 7.9 (p = 0.1633) and LR was 8.3 (p = 0.1393) which was not statistically significant. Adjusted vs unadjusted analyses Race is not associated with a higher re-ablation rate within 3 years of readmission in adjusted (for age and gender) and unadjusted analyses. Pairwise comparison tests with Tukey-Kramer adjustment indicate that there’s no significant difference among distinct racial groups (White, AFAM, Hispanic, and Other) when controlling for age group and sex. Table 1 Pairwise Comparison Results of Race Subgroup Unadjusted Differences of Non-White Races Least Squares Means Adjustment for Multiple Comparisons: Tukey-Kramer Standard Estimate Adj Lower Adj Upper RACE RACE Estimate Error z-value Pr > |z| Adj P Exp Exp Exp AFAM HISPANIC -0.0870 0.1279 -0.68 0.4964 0.9047 0.9167 0.6599 1.2733 AFAM OTHER -0.3257 0.1248 -2.61 0.0091 0.0448 0.7220 0.5239 0.9949 AFAM WHITE -0.2582 0.1060 -2.43 0.0149 0.0707 0.7725 0.5883 1.0143 HISPANIC OTHER -0.2387 0.1023 -2.33 0.0196 0.0906 0.7876 0.6056 1.0244 HISPANIC WHITE -0.1712 0.0782 -2.19 0.0285 0.1259 0.8427 0.6894 1.0301 OTHER WHITE 0.0676 0.0724 0.93 0.3504 0.7867 1.0699 0.8884 1.2885 Table 2 – Pairwise Comparison Between Each Race Subgroups Comparison df X 2 p -value reference p-value Results WHITE vs AFAM 1 5.1631 0.0231 0.0100 Not significant WHITE vs ASIAN 1 2.5653 0.1092 0.0100 Not significant WHITE vs HISP 1 0.0146 0.9038 0.0100 Not significant WHITE vs MULTOTH 1 0.0018 0.9666 0.0100 Not significant WHITE vs NATIVE 1 0.1938 0.6598 0.0100 Not significant Table 3 – Chi-Square Results and LR of Re-Ablation Between Whites and Non-Whites Statistic DF Value Prob Chi-Square 5 7.8750 0.1633 Likelihood Ratio 5 8.3235 0.1393 Phi Coefficient - 0.0183 - In pairwise comparisons of Whites to AFAM, Asian, Hispanic, Multi-ethnic, and Native American, we did not find statistically significant differences in the number of recurrent ablations. For example, when comparing the number of Whites to AFAM in incidence of recurrent ablation therapy, there was no statistically significant difference between the 2 races with a chi-square value of 5.16 (p = 0.0231) despite Whites showing a higher LR of having recurrent ablation therapy compared to AFAM. Table 4 – LR of Re-ablation when comparing White vs AFAM, White vs Other, and White vs Hispanic Comparison DF LR P-value (< 0.01) WHITE vs AFAM 1 5.0548 0.0246 WHITE vs OTHER 1 1.0116 0.3145 WHITE vs HISPANIC 1 4.2891 0.0384 Table 5 – Number of Re-ablations Performed Amongst White vs Non-White Patients Race R-ablation 0 1 Total White 17350 2926 20276 Nonwhite 2840 442 3282 Total 20190 3368 23558 Table 6 – Chi-Square Result and LR of Re-Ablation Difference Between White vs Non-White Patients Statistic DF Value Prob Chi-Square 1 2.1400 0.1435 Likelihood Ratio Chi-Square 1 2.1698 0.1407 Phi Coefficient -0.0095 When comparing White patients to Non-White patients, we did not find a statistical significance in the rate of re-ablation. The LR of having recurrent AF ablation was 2.17 (p = 0.1407) which was not statistically significant and had a weak relationship as evidenced by a very low Phi coefficient. Table 7 – Number of Re-Ablations Performed Amongst White vs Non-White Race Groups Race Re-ablation 0 (No) 1 (Yes) Total White 17350 2926 20276 Hispanic 1410 203 1613 Other 1352 246 1598 AFAM 794 106 900 Total 20190 3368 23558 Table 8 – Chi-Square Result and LR of Re-Ablation Difference Between White vs Non-White Subgroups As listed in Table 7 Statistic DF Value Prob Chi-Square 3 10.5369 0.0145 LR Chi-Square 3 10.8912 0.0123 Phi Coefficient 0.0211 However, the LR of 10.89 (p = 0.0123) may indicate that Whites had a higher statistically significant number of repeat ablations when compared to the other racial groups when divided into White vs Hispanic/AFAM/Other however this was not evident in the individual pairwise comparisons. Table 9 Gender Based Re-ablation Rate Difference Adjusted for Race and Age Analysis of Maximum Likelihood Estimates Odds Ratio Estimates Parameter DF Estimate Standard Wald Pr > ChiSq Point 95% Wald Error Chi-Square Estimate Confidence Limits Intercept 1 -2.0936 0.0781 719.1793 < .0001 SEX F 1 0.0547 0.0390 1.9642 0.1611 1.056 0.978 1.140 SEX M 0 0.0000 . . . RACE 1 AFAM 1 -0.2582 0.1060 5.9285 0.0149 0.772 0.628 0.951 RACE 2 HISPANIC 1 -0.1712 0.0782 4.7968 0.0285 0.843 0.723 0.982 RACE 3 OTHER 1 0.0676 0.0724 0.8720 0.3504 1.070 0.928 1.233 RACE 4 WHITE 0 0 . . . Age Group1 50_59 1 0.3527 0.0887 15.824 < .0001 1.423 1.196 1.693 Age Group2 60_69 1 0.3598 0.0817 19.371 < .0001 1.433 1.221 1.682 Age Group3 70_79 1 0.2681 0.0819 10.7269 0.0011 1.307 1.114 1.535 Age Group4 Below_50 1 0.2959 0.1053 7.9013 0.0049 1.344 1.094 1.652 Age Group5 80_plus 0 0 . . . Sex is also not significantly associated with the likelihood of Re-ablation in 3 years when controlling for race and age group ( \(\:{\chi\:}^{2}\left(1\right)\) =1.9642, p =.1611). Table 10 - COMORBIDITY F M HF 1818 3455 HF – Re-ablation 1131 1852 Percent Improvement 37.7% 46.3% Chi-squared 9.80 (p = 0.002) When assessing comorbidities and any statistical difference in the presence of heart failure (HF) post index ablation and post repeat ablation, there is a 91.2% decrease (p = 0.002) in incidence of heart failure in the repeat ablation group suggesting a statistical difference between changes in presence of HF amongst females and males. Table 11 Pairwise Comparison Results of Age_group Differences of Age_group Least Squares Means Adjustment for Multiple Comparisons: Tukey-Kramer Standard Estimate Adj Lower Adj Upper Age Group Age Group Estimate Error Z-Value Pr > |z| Adj P Exp Exp Exp 50–59 60–69 -0.00707 0.05526 -0.13 0.8982 0.9999 0.9930 0.854 1.1545 50–59 70–79 0.08457 0.05609 1.51 0.1316 0.5574 1.0883 0.9339 1.2682 50–59 Below 50 0.0568 0.08536 0.67 0.5058 0.9638 1.0584 0.8386 1.336 50–59 80 plus 0.3527 0.08866 3.98 < .0001 0.0007 1.4229 1.1172 1.8122 60–69 70–79 0.09164 0.04455 2.06 0.0397 0.2389 1.0960 0.9706 1.2376 60–69 Below 50 0.06387 0.07897 0.81 0.4186 0.9280 1.0660 0.8594 1.3222 60–69 80 plus 0.3598 0.08174 4.4 < .0001 0.0001 1.4330 1.1466 1.7909 70–79 Below 50 -0.02777 0.07969 -0.35 0.7275 0.9968 0.9726 0.7826 1.2088 70–79 80 plus 0.2681 0.08186 3.28 0.0011 0.0093 1.3075 1.0458 1.6346 Below 50 80_plus 0.2959 0.1053 2.81 0.0049 0.0396 1.3443 1.0088 1.7914 However, pairwise comparison tests among age groups found that patients over 80 has significantly lower odds of Re-ablation than patients below 80 when controlling for race and sex. Specifically, the odds of Re-ablation for 50s age group is 1.4229 (95% CI [1.1172, 1.8122]) times (42.29% higher) than the odds for 80s age group. Similarly, the odds ratio is 1.4330 (95% CI [1.1466, 1.7909]) for the 60s age group, 1.3075 (95%CI [1.0458, 1.6346]) for the 70s age group and 1.3443 (95% CI [1.0088, 1.7914]) for patients below 50 years when comparing with patients over 80 years old. Discussion We performed to our knowledge, the first multicenter retrospective analysis of hospital encounter data to determine if racial groups exhibit inherent differences in AF re-ablation rates after initial failure. While a statistical difference was found when race was dichotomized as white versus non-white, pairwise associations showed no significant difference. However, poor phi coefficients indicated limited practical significance. These common limitations in ablation cohorts necessitate further research into racial disparities in AF treatment. Although re-ablation rates did not differ significantly, this does not negate crucial variations in AF disease characteristics, treatment selection, or outcomes across racial/age groups. Prior research shows AFAM patients with AF are younger, more symptomatic, and have poorer cardiometabolic health (higher diabetes and hypertension), complicating initial and subsequent ablations. 9 Our study, however, suggests AFAM populations might have a lower AF recurrence post-ablation, which we attribute to altered diagnostic plans based on risk/socioeconomic factors, not genuinely reduced AF recurrence. This is supported by prior research, in which despite a paradoxically lower AF recurrence, AFAM patients on medication-based rhythm control had a 42% higher mortality risk over 40 months compared to White patients, emphasizing that differences in recurrence or intervention do not equate to improved clinical outcomes. 10 Genetic variation influences AF recurrence and treatment efficacy. European ancestry is linked to higher AF risk (10% increase in European ancestry suggests 13% increase in AF) and elevated pro-inflammatory markers, associating with a 42% race-AF link. 11 Conversely, African American (AFAM) populations often show a fibrosis-dominant atrial remodeling phenotype with increased collagen deposition and less atrial stretch, which may reduce the effectiveness of repeat ablation and increase conduction heterogeneity risk. 12 These biological, clinical, and socioeconomic differences likely influence AF re-ablation rates, even if statistical significance is absent due to limited power and representation in retrospective studies. A larger left atrial diameter (LAD), as shown in the Cardiovascular Health Study and the Heart and Soul Study, may predispose patients to index ablation failure and subsequent heart failure (HF). Our cohort showed sex-based differences in post-ablation HF prevalence, with repeat ablation offering a greater relative HF reduction in males than females. 5 – 6 While observational, this suggests rhythm control strategies may affect HF burden differently across sexes. The CASTLE-AF trial supports the clinical relevance of ablation-based rhythm control, demonstrating a significant reduction in death or HF hospitalization (HR ~ 0.62, p = 0.01) with ablation compared to medical therapy. 13 Although the CABANA trial found no significant difference between catheter ablation and antiarrhythmic drugs on HF presence, ablation therapy did improve quality of life scores and AF-specific symptom inventory. 14 Re-ablation rates were significantly lower in patients in their 70s and 80s compared to those in their 50s and 60s. This difference likely reflects clinical risk, access disparities, and risk-based decision-making, as younger patients often have longer life expectancies, fewer comorbidities, and better tolerance for repeat procedures. Additionally, younger patients tend to have paroxysmal or persistent AF, while older patients are more likely to have long-standing persistent AF, which affects ablation efficacy and clinical decisions. 15 Conclusion After adjustment for demographic factors an unstratified comparison suggested a potential difference in AF re-ablation rates between White and Non-White patients. However, this association did not persist following pairwise racial comparisons, including between White and African American patients, and no statistically significant differences. Accordingly, we accept that race is not independently associated with AF re-ablation following index ablation in this cohort. However, these findings cannot be interpreted as evidence of equivalent AF disease burden or clinical outcomes following re-ablations. Instead, this showcases the complexity of procedural recurrence from broader disparities in AF presentation, management, and ultimately the clinical outcome. Notably, age- and sex-based differences were observed with patients in their 50s-60s when compared to patients in their 70s-80s, and sex-based differences emerging in the prevalence of HF following repeat and index ablation, all together reflecting the known difference in AF treatment, phenotype and comorbidity burden, as well as the role of clinical decision making based off of risk assessment in treatment trajectories. Limitations This study has a few important limitations. The relatively small number of non-white patients limited statistical efficacy for race stratified and pairwise analyses, constraining the interpretation of observed associations. Furthermore, the retrospective design that relied on hospital encounter data, could be a product of variation in referral pattern, follow-up intensity and clinical decision making. Furthermore, socioeconomic factors, comorbidity burden, and access to care could influence observed trends in treatment outcome and trend pattern. Abbreviations AF: Atrial fibrillation AFL: Atrial flutter ADT: Antiarrhythmic drug therapy AFAM: African American APAF: Ablation for Paroxysmal Atrial Fibrillation (trial) CABANA: Catheter Ablation vs Antiarrhythmic Drug Therapy for Atrial Fibrillation (trial) CARDIA: Coronary Artery Risk Development in Young Adults (study) CO: Cardiac output CPVA: Circumferential pulmonary vein ablation CVD: Cardiovascular disease HF: Heart failure LA: Left atrium LAD: Left atrial diameter LR: Likelihood ratio LV: Left ventricle MESA: Multi-Ethnic Study of Atherosclerosis OR: Odds ratio RA: Right atrium RFA: Radiofrequency ablation SBP: Systolic blood pressure SV: Stroke volume Declarations Ethics approval and consent to participate: This study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board (IRB) of HCA Florida JFK Hospital. Given the observational retrospective nature of the study and use of de-identified data, the requirement for informed consent was waived. Consent for publication: Not Applicable Availability of data and materials: The datasets used and analyzed during the study are not publicly available due to institutional restrictions and patient privacy laws such as (HIPPA) compliance with the law but are available from the corresponding author on reasonable request. Competing Interests: The authors declare that they have no competing interests. Funding: Not Applicable Authors Contributions: AA (Aadavan Elangovan) contributed to data analysis and manuscript drafting. JA (Juzer Ali Asgar) contributed to study conception, supervision and critical revision. LEA (Leonard Efuet-Ateh) and AI (Angelina Isaac) contributed to figure design and data interpretation. MD (Mariel Duchow), AB (Amal Benchakroun), AP (Alok Pant), and RC (Robert Chait) contributed to clinical insight, feedback, and final manuscript approval All authors read and approved the final manuscript. Acknowledgements: Not Applicable References Flautt T, Valderrabano M. Recent clinical trials in atrial fibrillation. Curr Opin Cardiol. 2021;36(6):798–802. https://doi.org/10.1097/HCO.0000000000000914 . Mehrzad R, Rajab M, Spodick DH. The three integrated phases of left atrial macrophysiology and their interactions. Int J Mol Sci. 2014;15(9):15146–60. https://doi.org/10.3390/ijms150915146 . Caplan LR, D'Cruz I, Hier DB, Reddy H, Shah S. Atrial size, atrial fibrillation, and stroke. Ann Neurol. 1986;19(2):158–61. https://doi.org/10.1002/ana.410190208 . Dewland TA, Bibbins-Domingo K, Lin F, Vittinghoff E, Foster E, Ogunyankin KO, Lima JA, Jacobs DR, Hu D, Burchard EG, Marcus GM. 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Heart rhythm. 2021;O2(1):37–45. https://doi.org/10.1016/j.hroo.2021.01.001 . Marrouche NF, Wilber D, Hindricks G, et al. Association of Atrial Tissue Fibrosis Identified by Delayed Enhancement MRI and Atrial Fibrillation Catheter Ablation: The DECAAF Study. JAMA. 2014;311(5):498–506. 10.1001/jama.2014.3 . Packer DL, Mark DB, Robb RA, Monahan KH, Bahnson TD, Moretz K, Poole JE, Mascette A, Rosenberg Y, Jeffries N, Al-Khalidi HR, Lee KL,CABANA Investigators. Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation (CABANA) Trial: Study Rationale and Design. Am Heart J. 2018;199:192–9. https://doi.org/10.1016/j.ahj.2018.02.015 . Boehmer AA, Rothe M, Ruckes C, Eckardt L, Kaess BM, Ehrlich JR. Catheter Ablation for Atrial Fibrillation in Elderly Patients: an Updated Meta-analysis of Comparative Studies. Can J Cardiol. 2024;40(12):2441–51. https://doi.org/10.1016/j.cjca.2024.08.263 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 08 Apr, 2026 Reviewers agreed at journal 30 Mar, 2026 Reviewers invited by journal 30 Mar, 2026 Editor assigned by journal 22 Mar, 2026 Editor invited by journal 18 Mar, 2026 Submission checks completed at journal 18 Mar, 2026 First submitted to journal 17 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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Elangovan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABDUlEQVRIiWNgGAWjYDACdiS2BIjgZ2B8eICBgRm3FmQpsBbJBmYDErUYHCCghZ+Z+dnDLxWH5c3ZDz+88bPNLs/4RjLDAYYK68QGHFokm9nMjWXOHDbc2ZNmbNnbllxsBtZyJh2nFoPDDGbSkm1pjBsOJJhJ8JxhTtx2I//AAca2wzi12B9m/wbSYr/h/PNvkn/O1CdungG0hfEfbi0GzDxmkh/bbBI33Mgxk+apOJy4QQKkpQG3FonDPGXSDGdskjfceFNsLVNxPHHGmccMBxKOpRvj0sLf3r5N8keFhO2G8+kbb74xqE7sb09mfPChxloWlxYQYObBEErAoxwEGH8QUDAKRsEoGAUjHAAAPdxeG1dt/vwAAAAASUVORK5CYII=","orcid":"","institution":"University of Florida","correspondingAuthor":true,"prefix":"","firstName":"Aadavan","middleName":"","lastName":"Elangovan","suffix":""},{"id":614792473,"identity":"813258ee-c9fe-4e57-bc7b-492455557d16","order_by":2,"name":"Leonard Efuet-Ateh","email":"","orcid":"","institution":"University of Miami","correspondingAuthor":false,"prefix":"","firstName":"Leonard","middleName":"","lastName":"Efuet-Ateh","suffix":""},{"id":614792474,"identity":"bc69c1da-16d2-4440-a180-9777b4ac99dc","order_by":3,"name":"Angelina Isaac","email":"","orcid":"","institution":"American Heritage Palm Beach High School","correspondingAuthor":false,"prefix":"","firstName":"Angelina","middleName":"","lastName":"Isaac","suffix":""},{"id":614792475,"identity":"62f281f9-37b4-4e81-880e-883b2aeeb9df","order_by":4,"name":"Mariel Duchow","email":"","orcid":"","institution":"University of Washington","correspondingAuthor":false,"prefix":"","firstName":"Mariel","middleName":"","lastName":"Duchow","suffix":""},{"id":614792476,"identity":"df069c12-2e3f-422b-859f-11274b4d7c8a","order_by":5,"name":"Amal Benchakroun","email":"","orcid":"","institution":"UT Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Amal","middleName":"","lastName":"Benchakroun","suffix":""},{"id":614792477,"identity":"5e45a599-74e7-4b23-8521-42df4c774e09","order_by":6,"name":"Alok Pant","email":"","orcid":"","institution":"Louisiana State University Health Sciences","correspondingAuthor":false,"prefix":"","firstName":"Alok","middleName":"","lastName":"Pant","suffix":""},{"id":614792478,"identity":"f79781ca-e735-477b-8228-bc43ba8955fc","order_by":7,"name":"Robert Chait","email":"","orcid":"","institution":"University of Miami","correspondingAuthor":false,"prefix":"","firstName":"Robert","middleName":"","lastName":"Chait","suffix":""}],"badges":[],"createdAt":"2026-03-13 07:08:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9111318/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9111318/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105984206,"identity":"c81f7891-546e-4252-9e45-b5daf4cdb0e2","added_by":"auto","created_at":"2026-04-02 07:13:30","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":34314,"visible":true,"origin":"","legend":"\u003cp\u003eUnnumbered image in the Methods section.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9111318/v1/ef84206921d80e41fd3a906b.png"},{"id":105984366,"identity":"f86c5595-ce91-4bcb-a26f-b9e17dad94d8","added_by":"auto","created_at":"2026-04-02 07:13:48","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":945791,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9111318/v1/28c70677-5ee6-4c4a-83a3-b0e19092c127.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Racial Disparities in Atrial Fibrillation Treatment: A Closer Look at Repeat Ablation Outcomes","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAtrial fibrillation (AF), the most prevalent chronic cardiac arrhythmia in adults, significantly increases the risk of stroke, cardiac ischemia, and heart failure.\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e AF causes a loss of synchronized atrial contractions, decreasing stroke volume (SV) and thus cardiac output (CO). Left atrial (LA) function involves three integrated phases: reservoir, conduit, and booster-pump (contractile). Impairment of any phase, especially the contractile phase, reduces CO by up to 20%.\u003csup\u003e2\u003c/sup\u003e This hemodynamic deficit is poorly compensated, leading to elevated LA and right atrial (RA) pressures, which predispose the atrial myocardium to dilation and AF propagation.\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003ePrevious studies have examined racial differences in comorbidities and AF risk. The CARDIA study, a prospective cohort of young Black and White adults (ages 18–30, 1985–1986), found that Black individuals had higher SBP, were more often on antihypertensives, smoked more, and had greater LV mass. However, after adjusting for demographics and comorbidities, White individuals had a larger left atrial diameter (LAD) than Black individuals (unadjusted LAD was the opposite).\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e Similar racial LAD differences were noted in individuals over 65 with high CVD burden (The Cardiovascular Health Study and the Heart and Soul Study), where Whites had an approximate 2 mm larger LAD. A 5mm larger LAD is linked to a 40% higher AF risk.\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e5\u003c/span\u003e–\u003cspan class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e Despite this and similar comorbidities observed in studies like Framingham and MESA, a racial paradox exists: Blacks have a lower incidence of AF than Whites.\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eRacial differences in AF risk necessitate examining management strategies, particularly ablation versus antiarrhythmic drugs (ADT). The APAF trial showed circumferential pulmonary vein ablation (CPVA) was superior to ADT for maintaining sinus rhythm in selected patients, though it didn't assess race.\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e Radiofrequency ablation (RFA) improves cardiac output by achieving sinus rhythm and aiding left atrial remodeling. However, data is scarce on whether ablation strategies are utilized or effective differently across demographics. Addressing this critical gap, we will study disparities in AF recurrence requiring repeat ablations across gender, age, and race.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Method","content":"\u003cp\u003eThis multi-center retrospective cohort study looked at all encounters for adults (18+) who had an ablation procedure for AF between 1/1/2018-06/30/2020 at a multi-center hospital group.. Then within these encounters, the ones readmitted over the course of 3 years with AF/AFL were isolated. Initial encounters were 25,315, 54 removed due to unknown sex. The remaining 25,261 were further evaluated, 228 removed as they did not have AF, and 1475 duplicated encounters. The remaining encounters were 23,558 that included patients with history of index AF ablation who were readmitted for AF or other diagnoses, found to have recurrence of AF within a 3-year period. Chi-square and multivariate adjusted analyses were conducted to assess statistical significance amongst various ethnic groups.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe initial clinical hypothesis regarding racial disparity is that the patient\u0026rsquo;s race is associated with a difference in repeat AF ablation within 3 years of the initial hospital encounter. The race of patients was divided into White, Asian, African American, Multi-ethnicity or other, Hispanic, and Native-American. We performed multiple pairwise comparisons to evaluate any statistical difference between Whites and all other racial/ethnic groups. The total re-ablation rate for AF in readmission within 3 years was 14.3% (N\u0026thinsp;=\u0026thinsp;3368/23558). Using a chi-square test to compare the rate of AF re-ablation to those who didn\u0026rsquo;t, the result was 7.9 (p\u0026thinsp;=\u0026thinsp;0.1633) and LR was 8.3 (p\u0026thinsp;=\u0026thinsp;0.1393) which was not statistically significant.\u003c/p\u003e \u003cp\u003eAdjusted vs unadjusted analyses\u003c/p\u003e \u003cp\u003eRace is not associated with a higher re-ablation rate within 3 years of readmission in adjusted (for age and gender) and unadjusted analyses. Pairwise comparison tests with Tukey-Kramer adjustment indicate that there\u0026rsquo;s no significant difference among distinct racial groups (White, AFAM, Hispanic, and Other) when controlling for age group and sex.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePairwise Comparison Results of Race Subgroup Unadjusted\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"10\" nameend=\"c10\" namest=\"c1\"\u003e \u003cp\u003eDifferences\u0026nbsp;of\u0026nbsp;Non-White Races\u0026nbsp;Least\u0026nbsp;Squares\u0026nbsp;Means\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"10\" nameend=\"c10\" namest=\"c1\"\u003e \u003cp\u003eAdjustment\u0026nbsp;for\u0026nbsp;Multiple\u0026nbsp;Comparisons:\u0026nbsp;Tukey-Kramer\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStandard\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eEstimate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eAdj\u0026nbsp;Lower\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eAdj\u0026nbsp;Upper\u003c/p\u003e \u003c/th\u003e 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colname=\"c8\"\u003e \u003cp\u003e0.7876\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.6056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.0244\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHISPANIC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWHITE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.1712\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.0782\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.0285\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.1259\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.8427\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.6894\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.0301\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOTHER\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWHITE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.0676\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.0724\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.3504\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.7867\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.0699\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.8884\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.2885\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u0026ndash; Pairwise Comparison Between Each Race Subgroups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComparison\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003edf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ereference p-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eResults\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWHITE vs AFAM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.1631\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.0231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot significant\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWHITE vs ASIAN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.5653\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.1092\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot significant\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWHITE vs HISP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.9038\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot significant\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWHITE vs MULTOTH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.9666\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot significant\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWHITE vs NATIVE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.1938\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.6598\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot significant\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u0026ndash; Chi-Square Results and LR of Re-Ablation Between Whites and Non-Whites\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStatistic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eValue\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProb\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChi-Square\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.8750\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.1633\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLikelihood Ratio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.3235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.1393\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhi Coefficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn pairwise comparisons of Whites to AFAM, Asian, Hispanic, Multi-ethnic, and Native American, we did not find statistically significant differences in the number of recurrent ablations. For example, when comparing the number of Whites to AFAM in incidence of recurrent ablation therapy, there was no statistically significant difference between the 2 races with a chi-square value of 5.16 (p\u0026thinsp;=\u0026thinsp;0.0231) despite Whites showing a higher LR of having recurrent ablation therapy compared to AFAM.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u0026ndash; LR of Re-ablation when comparing White vs AFAM, White vs Other, and White vs Hispanic\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComparison\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP-value (\u0026lt;\u0026thinsp;0.01)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWHITE vs AFAM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.0548\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.0246\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWHITE vs OTHER\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.0116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.3145\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWHITE vs HISPANIC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.2891\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.0384\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u0026ndash; Number of Re-ablations Performed Amongst White vs Non-White Patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRace\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eR-ablation\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2926\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20276\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNonwhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2840\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e442\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3282\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3368\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23558\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u0026ndash; Chi-Square Result and LR of Re-Ablation Difference Between White vs Non-White Patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStatistic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eValue\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProb\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChi-Square\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.1400\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.1435\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLikelihood Ratio Chi-Square\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.1698\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.1407\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhi Coefficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.0095\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWhen comparing White patients to Non-White patients, we did not find a statistical significance in the rate of re-ablation. The LR of having recurrent AF ablation was 2.17 (p\u0026thinsp;=\u0026thinsp;0.1407) which was not statistically significant and had a weak relationship as evidenced by a very low Phi coefficient.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u0026ndash; Number of Re-Ablations Performed Amongst White vs Non-White Race Groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRace\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eRe-ablation\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (No)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (Yes)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2926\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20276\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHispanic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1410\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e203\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1613\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1352\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e246\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1598\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAFAM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e794\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e900\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3368\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23558\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u0026ndash; Chi-Square Result and LR of Re-Ablation Difference Between White vs Non-White Subgroups As listed in Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStatistic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eValue\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProb\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChi-Square\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.5369\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.0145\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLR Chi-Square\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.8912\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.0123\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhi Coefficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eHowever, the LR of 10.89 (p\u0026thinsp;=\u0026thinsp;0.0123) may indicate that Whites had a higher statistically significant number of repeat ablations when compared to the other racial groups when divided into White vs Hispanic/AFAM/Other however this was not evident in the individual pairwise comparisons.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab9\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 9\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eGender Based Re-ablation Rate Difference Adjusted for Race and Age\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003eAnalysis of Maximum Likelihood Estimates\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c11\" namest=\"c9\"\u003e \u003cp\u003eOdds\u0026nbsp;Ratio\u0026nbsp;Estimates\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParameter\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEstimate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStandard\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWald\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ePr\u0026nbsp;\u0026gt;\u0026nbsp;ChiSq\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003ePoint\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c11\" namest=\"c10\"\u003e \u003cp\u003e95%\u0026nbsp;Wald\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eError\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eChi-Square\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003eEstimate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c11\" namest=\"c10\"\u003e \u003cp\u003eConfidence\u0026nbsp;Limits\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntercept\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-2.0936\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0781\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e719.1793\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSEX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.0547\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0390\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.9642\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.1611\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e1.056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.978\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.140\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSEX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.0000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRACE 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAFAM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.2582\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.1060\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.9285\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.0149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.772\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.628\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.951\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRACE 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHISPANIC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.1712\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0782\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.7968\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.0285\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.843\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.723\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.982\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRACE 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOTHER\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.0676\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0724\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.8720\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.3504\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e1.070\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.928\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.233\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRACE 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWHITE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge Group1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50_59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.3527\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0887\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15.824\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e1.423\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.693\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge Group2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60_69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.3598\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0817\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.371\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e1.433\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.221\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.682\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge Group3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70_79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.2681\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0819\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.7269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.0011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e1.307\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.535\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge Group4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBelow_50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.2959\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.1053\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.9013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.0049\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e1.344\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.652\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge Group5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80_plus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eSex is also not significantly associated with the likelihood of Re-ablation in 3 years when controlling for race and age group (\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{\\chi\\:}^{2}\\left(1\\right)\\)\u003c/span\u003e\u003c/span\u003e=1.9642, \u003cem\u003ep\u003c/em\u003e=.1611).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab10\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 10\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOMORBIDITY\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1818\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3455\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHF \u0026ndash; Re-ablation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1852\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePercent Improvement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChi-squared\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e9.80 (p\u0026thinsp;=\u0026thinsp;0.002)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWhen assessing comorbidities and any statistical difference in the presence of heart failure (HF) post index ablation and post repeat ablation, there is a 91.2% decrease (p\u0026thinsp;=\u0026thinsp;0.002) in incidence of heart failure in the repeat ablation group suggesting a statistical difference between changes in presence of HF amongst females and males.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab11\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 11\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePairwise Comparison Results of Age_group\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"10\" nameend=\"c10\" namest=\"c1\"\u003e \u003cp\u003eDifferences\u0026nbsp;of\u0026nbsp;Age_group\u0026nbsp;Least\u0026nbsp;Squares\u0026nbsp;Means\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"10\" nameend=\"c10\" namest=\"c1\"\u003e \u003cp\u003eAdjustment\u0026nbsp;for\u0026nbsp;Multiple\u0026nbsp;Comparisons:\u0026nbsp;Tukey-Kramer\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003eStandard\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eEstimate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eAdj\u0026nbsp;Lower\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eAdj\u0026nbsp;Upper\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge Group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eAge Group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eEstimate\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eError\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eZ-Value\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003ePr \u0026gt; |z|\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eAdj P\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003eExp\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eExp\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003eExp\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u0026ndash;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.00707\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.05526\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.8982\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.9999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.9930\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.854\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.1545\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70\u0026ndash;79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.08457\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.05609\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.1316\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.5574\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.0883\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.9339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.2682\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBelow 50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.0568\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.08536\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.5058\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.9638\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.0584\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.8386\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.336\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 plus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.3527\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.08866\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.0007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.4229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.1172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.8122\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60\u0026ndash;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70\u0026ndash;79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.09164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.04455\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.0397\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.2389\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.0960\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.9706\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.2376\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60\u0026ndash;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBelow 50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.06387\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.07897\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.4186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.9280\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.0660\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.8594\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.3222\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60\u0026ndash;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 plus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.3598\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.08174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.4330\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.1466\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.7909\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e70\u0026ndash;79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBelow 50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.02777\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.07969\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.7275\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.9968\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.9726\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.7826\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.2088\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e70\u0026ndash;79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 plus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.2681\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.08186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.0011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.0093\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.3075\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.0458\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.6346\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBelow 50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80_plus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.2959\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.1053\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.0049\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.0396\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.3443\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.0088\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.7914\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eHowever, pairwise comparison tests among age groups found that patients over 80 has significantly lower odds of Re-ablation than patients below 80 when controlling for race and sex. Specifically, the odds of Re-ablation for 50s age group is 1.4229 (95% CI [1.1172, 1.8122]) times (42.29% higher) than the odds for 80s age group. Similarly, the odds ratio is 1.4330 (95% CI [1.1466, 1.7909]) for the 60s age group, 1.3075 (95%CI [1.0458, 1.6346]) for the 70s age group and 1.3443 (95% CI [1.0088, 1.7914]) for patients below 50 years when comparing with patients over 80 years old.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eWe performed to our knowledge, the first multicenter retrospective analysis of hospital encounter data to determine if racial groups exhibit inherent differences in AF re-ablation rates after initial failure. While a statistical difference was found when race was dichotomized as white versus non-white, pairwise associations showed no significant difference. However, poor phi coefficients indicated limited practical significance. These common limitations in ablation cohorts necessitate further research into racial disparities in AF treatment.\u003c/p\u003e \u003cp\u003eAlthough re-ablation rates did not differ significantly, this does not negate crucial variations in AF disease characteristics, treatment selection, or outcomes across racial/age groups. Prior research shows AFAM patients with AF are younger, more symptomatic, and have poorer cardiometabolic health (higher diabetes and hypertension), complicating initial and subsequent ablations.\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e Our study, however, suggests AFAM populations might have a lower AF recurrence post-ablation, which we attribute to altered diagnostic plans based on risk/socioeconomic factors, not genuinely reduced AF recurrence. This is supported by prior research, in which despite a paradoxically lower AF recurrence, AFAM patients on medication-based rhythm control had a 42% higher mortality risk over 40 months compared to White patients, emphasizing that differences in recurrence or intervention do not equate to improved clinical outcomes.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eGenetic variation influences AF recurrence and treatment efficacy. European ancestry is linked to higher AF risk (10% increase in European ancestry suggests 13% increase in AF) and elevated pro-inflammatory markers, associating with a 42% race-AF link.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e Conversely, African American (AFAM) populations often show a fibrosis-dominant atrial remodeling phenotype with increased collagen deposition and less atrial stretch, which may reduce the effectiveness of repeat ablation and increase conduction heterogeneity risk.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e These biological, clinical, and socioeconomic differences likely influence AF re-ablation rates, even if statistical significance is absent due to limited power and representation in retrospective studies.\u003c/p\u003e \u003cp\u003eA larger left atrial diameter (LAD), as shown in the Cardiovascular Health Study and the Heart and Soul Study, may predispose patients to index ablation failure and subsequent heart failure (HF). Our cohort showed sex-based differences in post-ablation HF prevalence, with repeat ablation offering a greater relative HF reduction in males than females.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e While observational, this suggests rhythm control strategies may affect HF burden differently across sexes. The CASTLE-AF trial supports the clinical relevance of ablation-based rhythm control, demonstrating a significant reduction in death or HF hospitalization (HR\u0026thinsp;~\u0026thinsp;0.62, p\u0026thinsp;=\u0026thinsp;0.01) with ablation compared to medical therapy.\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e Although the CABANA trial found no significant difference between catheter ablation and antiarrhythmic drugs on HF presence, ablation therapy did improve quality of life scores and AF-specific symptom inventory.\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eRe-ablation rates were significantly lower in patients in their 70s and 80s compared to those in their 50s and 60s. This difference likely reflects clinical risk, access disparities, and risk-based decision-making, as younger patients often have longer life expectancies, fewer comorbidities, and better tolerance for repeat procedures. Additionally, younger patients tend to have paroxysmal or persistent AF, while older patients are more likely to have long-standing persistent AF, which affects ablation efficacy and clinical decisions.\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eAfter adjustment for demographic factors an unstratified comparison suggested a potential difference in AF re-ablation rates between White and Non-White patients. However, this association did not persist following pairwise racial comparisons, including between White and African American patients, and no statistically significant differences. Accordingly, we accept that race is not independently associated with AF re-ablation following index ablation in this cohort. However, these findings cannot be interpreted as evidence of equivalent AF disease burden or clinical outcomes following re-ablations. Instead, this showcases the complexity of procedural recurrence from broader disparities in AF presentation, management, and ultimately the clinical outcome. Notably, age- and sex-based differences were observed with patients in their 50s-60s when compared to patients in their 70s-80s, and sex-based differences emerging in the prevalence of HF following repeat and index ablation, all together reflecting the known difference in AF treatment, phenotype and comorbidity burden, as well as the role of clinical decision making based off of risk assessment in treatment trajectories.\u003c/p\u003e \u003cp\u003eLimitations\u003c/p\u003e \u003cp\u003eThis study has a few important limitations. The relatively small number of non-white patients limited statistical efficacy for race stratified and pairwise analyses, constraining the interpretation of observed associations. Furthermore, the retrospective design that relied on hospital encounter data, could be a product of variation in referral pattern, follow-up intensity and clinical decision making. Furthermore, socioeconomic factors, comorbidity burden, and access to care could influence observed trends in treatment outcome and trend pattern.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAF: Atrial fibrillation\u003c/p\u003e\n\u003cp\u003eAFL: Atrial flutter\u003c/p\u003e\n\u003cp\u003eADT: Antiarrhythmic drug therapy\u003c/p\u003e\n\u003cp\u003eAFAM: African American\u003c/p\u003e\n\u003cp\u003eAPAF: Ablation for Paroxysmal Atrial Fibrillation (trial)\u003c/p\u003e\n\u003cp\u003eCABANA: Catheter Ablation vs Antiarrhythmic Drug Therapy for Atrial Fibrillation (trial)\u003c/p\u003e\n\u003cp\u003eCARDIA: Coronary Artery Risk Development in Young Adults (study)\u003c/p\u003e\n\u003cp\u003eCO: Cardiac output\u003c/p\u003e\n\u003cp\u003eCPVA: Circumferential pulmonary vein ablation\u003c/p\u003e\n\u003cp\u003eCVD: Cardiovascular disease\u003c/p\u003e\n\u003cp\u003eHF: Heart failure\u003c/p\u003e\n\u003cp\u003eLA: Left atrium\u003c/p\u003e\n\u003cp\u003eLAD: Left atrial diameter\u003c/p\u003e\n\u003cp\u003eLR: Likelihood ratio\u003c/p\u003e\n\u003cp\u003eLV: Left ventricle\u003c/p\u003e\n\u003cp\u003eMESA: Multi-Ethnic Study of Atherosclerosis\u003c/p\u003e\n\u003cp\u003eOR: Odds ratio\u003c/p\u003e\n\u003cp\u003eRA: Right atrium\u003c/p\u003e\n\u003cp\u003eRFA: Radiofrequency ablation\u003c/p\u003e\n\u003cp\u003eSBP: Systolic blood pressure\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;SV: Stroke volume\u003c/p\u003e"},{"header":"Declarations","content":"\u003cul\u003e\n \u003cli\u003eEthics approval and consent to participate:\u003cbr\u003e\u0026nbsp;This study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board (IRB) of HCA Florida JFK Hospital. Given the observational retrospective nature of the study and use of de-identified data, the requirement for informed consent was waived.\u003c/li\u003e\n \u003cli\u003eConsent for publication:\u003cbr\u003e\u0026nbsp;Not Applicable\u003c/li\u003e\n \u003cli\u003eAvailability of data and materials:\u003cbr\u003e\u0026nbsp;The datasets used and analyzed during the study are not publicly available due to institutional restrictions and patient privacy laws such as (HIPPA) compliance with the law but are available from the corresponding author on reasonable request.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eCompeting Interests:\u003cbr\u003e\u0026nbsp;The authors declare that they have no competing interests.\u003c/li\u003e\n \u003cli\u003eFunding:\u003cbr\u003e\u0026nbsp;Not Applicable\u003c/li\u003e\n \u003cli\u003eAuthors Contributions:\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eAA (Aadavan Elangovan) contributed to data analysis and manuscript drafting. JA (Juzer Ali Asgar) contributed to study conception, supervision and critical revision. LEA (Leonard Efuet-Ateh) and AI (Angelina Isaac) contributed to figure design and data interpretation. MD (Mariel Duchow), AB (Amal Benchakroun), AP (Alok Pant), and RC (Robert Chait) contributed to clinical insight, feedback, and final manuscript approval All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eAcknowledgements:\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eFlautt T, Valderrabano M. Recent clinical trials in atrial fibrillation. 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Can J Cardiol. 2024;40(12):2441\u0026ndash;51. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.cjca.2024.08.263\u003c/span\u003e\u003cspan address=\"10.1016/j.cjca.2024.08.263\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-9111318/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9111318/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eIntroduction: Atrial Fibrillation (AF) is the most prevalent chronic cardiac arrhythmia in adults, often leading to higher risk for further significant cardiac comorbidities. Atrial fibrillation is a disease with known disparities across racial groups, but repeat ablation outcomes are not well characterized currently.\u003c/p\u003e \u003cp\u003eObjective: We aimed to retrospectively evaluate whether race was associated with discrete differences with repeat AF Ablation within 3 years after an index ablation, while also examining age- and gender- based differences.\u003c/p\u003e \u003cp\u003eMethod: We performed a multicenter retrospective cohort study with a population of adults over the age of 18, with AF Ablation between 1/1/2018, and 6/30/2020. We had over 23,558 encounters after excluding encounters that didn't belong within our parameters. Our primary outcome was to evaluate repeat ablation and readmission data with atrial fibrillation within 3 years. We elucidated statistics using chi-square plus multivariable adjusted analysis for age and sex based demographics, with pairwise racial subgroup comparisons.\u003c/p\u003e \u003cp\u003eResults: The overall repeat ablation rate was 14.3% (N\u0026thinsp;=\u0026thinsp;3368/23558). In the overall racial comparison, race was not significantly associated with repeat ablation rates (chi-square\u0026thinsp;=\u0026thinsp;7.875, p\u0026thinsp;=\u0026thinsp;0.1633; likelihood ratio\u0026thinsp;=\u0026thinsp;8.3235, p = .1393). We also saw little statistical significance of white versus non-white patients, (chi-square\u0026thinsp;=\u0026thinsp;2.1400, p\u0026thinsp;=\u0026thinsp;0.1435). Pairwise subgroup comparisons did not demonstrate significant differences after multiple-comparison adjustment. In adjusted analyses, sex was not significantly associated with repeat ablation (p\u0026thinsp;=\u0026thinsp;0.1611), whereas patients younger than 80 years had higher odds of repeat ablation compared with those aged 80 years and older, including ages 50\u0026ndash;59 (OR 1.423), 60\u0026ndash;69 (OR 1.433), 70\u0026ndash;79 (OR 1.307), and \u0026lt;\u0026thinsp;50 (OR 1.344).\u003c/p\u003e \u003cp\u003eConclusion: In this multicenter retrospective cohort, race did not show an independent association with repeat AF ablation within 3 years of index ablation. However, these findings do not interpret itself as evidence of AF burden or treatment experience to be equivalent amongst racial groups. Furthermore, age-related differences in repeat ablation suggest that treatment prognostication varies amongst patient subgroups warranting further study in larger datasets.\u003c/p\u003e","manuscriptTitle":"Racial Disparities in Atrial Fibrillation Treatment: A Closer Look at Repeat Ablation Outcomes","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-02 07:12:33","doi":"10.21203/rs.3.rs-9111318/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-08T15:35:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"214302999287315081355523164102610544852","date":"2026-03-30T14:36:36+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-30T12:09:02+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-22T15:56:28+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-18T13:05:50+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-18T04:16:47+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Cardiovascular Disorders","date":"2026-03-17T22:54:54+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2f3f2e66-303c-406d-ab20-b3c1e4167619","owner":[],"postedDate":"April 2nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-02T07:12:33+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-02 07:12:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9111318","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9111318","identity":"rs-9111318","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}