Predictors and Outcomes of 30-Day Readmissions Following Electrical Cardioversion for Atrial Fibrillation: Insights From the Nationwide Readmissions Database

J Arrhythm. 2026 Jun 30;42(4):e70406. doi: 10.1002/joa3.70406. eCollection 2026 Aug.

ABSTRACT

BACKGROUND: Atrial Fibrillation (AF) affects 10.5 million adults in the US and is projected to reach 12.1 million by 2030, representing a growing burden. We evaluated predictors of 30-day readmission after electrical cardioversion (EC) for AF.

METHODS: In this retrospective observational cohort study using the Nationwide Readmissions Database (2016-2017), we identified adults with AF undergoing EC. Outcomes evaluated were 30-day all-cause readmission, in-hospital mortality, length of stay (LOS) and inflation-adjusted hospitalization charges. Multivariable logistic regression identified predictors of 30-day readmission.

RESULTS: Among 134 114 AF hospitalizations managed with EC, 13 260 (9.9%) were readmitted within 30 days. Readmitted patients (mean age 70, 51% male) had longer index stays (4 vs. 3 days), higher charges ($31 576 vs. $26 896), and more frequent nonhome discharges (11% vs. 6.4%; all p < 0.001). Readmissions added $27 994 in costs. In-hospital mortality was higher during readmission (2.9% vs. 0.7%). Independent predictors included female sex, Medicaid or Medicare coverage, and chronic pulmonary disease, hypertension, diabetes and heart failure (HF) (p < 0.001). Higher median household income was associated with lower odds of readmission (p < 0.001).

CONCLUSION: Nearly 1 in 10 AF patients treated with EC was readmitted within 30 days. Female sex, comorbidity burden and lower socioeconomic status were key predictors. Improved post-discharge care addressing comorbidities alongside rhythm management may reduce early readmissions.

PMID:42389455 | PMC:PMC13318945 | DOI:10.1002/joa3.70406