Abstract 15879: Impact of Pulmonary Hypertension on In-Hospital Outcomes for Patients Undergoing Typical Atrial Flutter Ablation

Abstract

Introduction: Pulmonary hypertension (PHT) is a progressive disease with a clinical course characterized by frequent decompensations in advanced stages. Atrial arrhythmias, including typical atrial flutter, are common in patients with PHT. We sought to investigate the effect of presence of pulmonary hypertension to the outcomes after typical atrial flutter ablation. Methods: We utilized the National Inpatient database from 2016 to 2019 to perform this study. By utilizing the ICD-10-CM codes all hospitalizations for typical atrial flutter ablation were identified. Patients with atypical flutter and ablation were excluded. Among these subjects, those with associated diagnosis of pulmonary hypertension (WHO Group 1 to 5) were identified and they formed the study group. Primary outcome was to in-hospital mortality and complications. Secondary outcomes included analysis of patient clinical characteristics, length of hospital stay (LOS) and total hospital charges (TOTCH). Multivariate regression analysis was used to predict outcomes. Results: A total of 7,784 patients with PHT were hospitalized for typical atrial flutter ablation during the study period. Patients with PHT were slightly older (66 vs 67 years, p<0.001). The proportion of males was lower in the PHT group (57vs 67 %, p<0.001). For Typical AFL patients undergoing ablation, the presence of PHT was associated with higher odds of mortality (a0R= 1.8, p=0.003), acute kidney injury (a0R= 1.6, p<0.001), heart failure exacerbation (a0R= 1.3, p<0.001) and cardiogenic shock (a0R= 2.2, p<0.001) on multivariate regression analysis. They also had higher LOS (+2.3 days, p<0.001) and TOTCH (+$30,501, p<0.001). Conclusion: Our data shows that pulmonary hypertension is independently associated with worse in-hospital outcomes in patients undergoing typical atrial flutter ablation, including higher mortality. Further prospective studies are required to confirm our findings.