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

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.