Po-01-007 geographical regional variation in patient characteristics and outcomes during ablation of paroxysmal atrial fibrillation in the real-af registry

Geographical regional variations in the use of catheter ablation for atrial fibrillation ablation have been described. We hypothesized that such differences, as well as other demographic regional variations, may have a significant impact on the baseline characteristics and outcomes of patients undergoing atrial fibrillation ablation. We sought to describe geographic variation in the characteristics and outcomes of patients who underwent catheter ablation for paroxysmal atrial fibrillation as part of the REAL-AF registry. REAL-AF is a prospective observational registry of patients undergoing ablation for atrial fibrillation. Baseline comorbidities, complications and arrhythmia free survival were determined and compared across paroxysmal atrial fibrillation patients in four US regions: South, North-east, Mid-west, and West. Categorical variables were compared using chi squared test. Continuous variables were assessed by ANOVA followed by Tukey HSD test. Kaplan Meier Curves were constructed to compare arrhythmia free survival. A total of 2745 patients underwent catheter ablation for paroxysmal atrial fibrillation as part of the REAL AF registry, and 1061 patients from 12 centers had long-term follow-up data. Patients enrolled from centers in the South had a comparatively greater number of comorbidities (2.1 ± 1.4) when compared to their counterparts in the Midwest ( 1.8 ± 1.5), West ( 1.6 ± 1.4), and Northeast ( 1.4 ± 1.0, comparison to mid-west also significant). CHADS2VASC scores echoed these findings. More specific findings are highlighted in the baseline characteristics table. Procedural complications were similar across regions (p> 0.05). There was significant regional variation in long-term outcomes with Southern patients having the best arrhythmia free survival despite the presence of higher comorbidities (see figure). Significant regional variation exists in baseline characteristics and outcomes of patients undergoing ablation for atrial fibrillation in the REAL AF registry. Higher comorbidities were noted in patients enrolled from the South, but this did not translate to worsened outcomes.