Abstract 13012: Atrial Fibrillation Symptom Improvement Following De Novo Catheter Ablation: Trajectories and Predictors of Symptom Resolution

Introduction: Atrial fibrillation (AF) symptom relief is a primary indication for catheter ablation, but the impact of ablation on AF symptoms is not well characterized. The objective of this study was to describe AF symptom documentation in electronic health records (EHRs) pre- and post-ablation and identify correlates of post-ablation symptoms. Methods: We evaluated EHRs of AF patients (n=1293) in a large, urban health system from 2010-2020 who underwent ablation and had at least one encounter note within 30 days of the ablation. We extracted structured data about patient demographics, medications, diagnoses, and encounters, and symptom data from unstructured clinical notes using natural language processing. We used Cochran’s Q tests with post-hoc McNemar’s tests to determine whether the prevalence of symptoms differed significantly pre- and 3, 6, 9, and 12 months post-ablation. We used bivariate logistic regression models to estimate the unadjusted odds of symptom prevalence by personal or clinical characteristics at 6 and 12 months post-ablation. Results: Compared to pre-ablation, the prevalence of any AF symptom decreased but anxiety and weakness increased post-ablation (Table 1). The unadjusted odds of any symptoms 12 months post-ablation were associated with Black/African-American (odds ratio [OR]=0.35; 95% confidence interval [CI]=0.14-0.92) or another race (OR=0.39, 95% CI=0.16-0.95) versus Asian race, Hispanic/Latino ethnicity (OR=2.40, 95% CI=1.28-4.39) versus non-Hispanic/Latino, antiarrhythmic medication (OR=0.62, 95% CI=0.46-0.80) versus no medication, smoking history (OR=0.70, 95% CI=0.53-0.94) versus no history, and heart failure (OR=0.73, 95% CI=0.55-0.97) versus no heart failure. Conclusion: Symptom patterns post-ablation are heterogeneous. Findings warrant confirmation with larger, more representative datasets, which may be informative for patients whose primary goal for undergoing an ablation is symptom relief.