Long- term outcomes following endocardial and epicardial ablation of atrial fibrillation in a low procedural volume hospital

Atrial Fibrillation (AFib) ablation volume and its relation to outcomes posit negatively for low volume centers, the ideal annual hospital volume is 50. Fifty four in-patients have been followed. The primary outcome is the change in an AFib validated outcomes questionnaire that subjects completed pre-procedure, 6 months, 1 year, and annually thereafter. Secondary endpoints included duration of maintaining normal sinus rhythm (NSR) and adverse events. At 6 months, the overall questionnaire score improved by 30 points from the baseline score (95% CI: (16, 43), p < 0.001). The improvement from baseline was also maintained at 1 year, with the 1-year change score of 22 points (95% CI: (14, 30), p < 0.001), additionally significant improvements were observed in each of the subscales. Based on a Kaplan-Meier analysis, 96% of subjects maintained NSR at 6 months, 87% maintained NSR at 1 year, and 78% maintained NSR at 2 years. Epicardial and endocardial ablation for AF care is feasible in a low-volume ablation hospital with careful long-term tracking. Patients can receive quality care closer to home and not incur costs associated with traveling for health care-a determinate of value- based care.