As the number of catheter ablation for atrial fibrillation increases, there is a strong need for quality and performance measures. @Helios-Kliniken, we have started to measure, monitor and peer-review in-hospital mortality and cardiac tamponade in atrial fibrillation ablation. This is complemented by patient-reported outcomes measures (PROMs).

1. The use of routine data
in AF ablation
Andreas Bollmann
Universitätsklinik für Kardiologie –
Helios Stiftungsprofessur
Abteilung für Rhythmologie for quality management
for outcomes research

2. Use of routine data in AF ablation – Background
Use of§21 KHEntgG
administrative data
in Germany

3. Use of routine data in AF ablation – Background

4. Use of routine data in AF ablation – Background

5. • Fast, timely and cost-effective availability
• Standardized data and data formats
• Complete and validated cases including demographic data
(age, gender), comorbidities (ICD-10 codes), procedures
(OPS codes), hospitalization (elective, emergency, hospital
transfer) and discharge details (home, hospital transfer,
death), length of stay
• Selection of well-defined cohorts possible
Use of routine data in AF ablation – Advantages

6. • No outcome data beyond hospital stay from different in- or
outpatient settings (e.g. rehospitalization for complications
or additional treatments, mortality)
-> link with data from insurers
• No medication, additional procedural (e.g. de-novo or
repeat ablation, mapping and ablation technology, intra- vs.
postprocedural cardioversion, operator) or QC data (e.g.
procedure and fluoroscopy time)
• No intention-to-treat data (e.g. respiratory, vascular or
cardiac complications before AF ablation)
-> link with hospital information system
Use of routine data in AF ablation – Limitations

7. In-hospital mortality in atrial fibrillation

8. In-hospital mortality in atrial fibrillation
König et al. Eur Heart J 2018

9. König et al. Eur Heart J 2018
In-hospital mortality in atrial fibrillation

10. In-hospital mortality in atrial fibrillation
König et al. Eur Heart J 2018

11. In-hospital mortality in AF/AFl ablation
Bollmann & Hindricks. Eur Heart J Qual Care Clin Outcomes. 2019

12. Cardiac tamponade in AF catheter ablation

13. Cardiac tamponade in AF catheter ablation
Bollmann et al. Europace 2018

14. Cardiac tamponade in AF catheter ablation
Bollmann et al. Europace 2018

15. Patient-reported outcome measures

16. Patient-reported outcome measures

17. Patient-reported outcome measures in AF – Call for public review

18. • Source for real-world evidence of safety (and efficacy) of
AF ablation and other treatments
• Useful for outcomes research and quality management
programs
• Complementary implementation of PROMs as important
step towards patient-centered care
Use of routine data in AF ablation – Summary