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Inhospital Complications Associated with Catheter Ablation of Atrial Fibrillation in the United States between 2000-2010: Analysis of 93,801 Procedures.
Circulation. 2013 Sep 23;
Authors: Deshmukh A, Patel NJ, Pant S, Shah N, Chothani A, Mehta K, Grover P, Singh V, Vallurupalli S, Savani GT, Badheka A, Tuliani T, Dabhadkar K, Dibu G, Reddy YM, Sewani A, Kowalski M, Mitrani R, Paydak H, Viles-Gonzalez JF
Abstract
BACKGROUND: AF ablation has tremendous progress with respect to innovation, efficacy and safety. However limited data exists regarding burden and trends in adverse outcomes arising from this procedure. The aim of our study was to examine frequency of adverse events due to Atrial Fibrillation (AF) ablation and influence of operator and hospital volume on outcomes.
METHODS AND RESULTS: Using the Nationwide Inpatient Sample (NIS) we identified AF patients treated with catheter ablation. We investigated common complications including cardiac perforation and/or tamponade, pneumothorax, stroke, transient ischemic attack (TIA), vascular access complication (consisting of hemorrhage/hematoma, vascular complication requiring surgical repair, and accidental arterial puncture), and in-hospital death described with AF ablation and defined them by validated International Classification of Diseases (9th Edition) Clinical Modification (ICD-9-CM) diagnosis codes. An estimated 93,801 AF ablations were from the 2000 to 2010. The overall frequency of complications was 6.29% with combined cardiac complications (2.54%) being the most frequent. It was followed by vascular complications (1.53%), respiratory complications (1.3%) and neurological complications (1.02%). The in-hospital mortality was 0.46%. Annual operator (<25 procedures) and hospital volume (<50 procedures) were significantly associated with adverse outcomes. There was a small (non-significant) rise in overall complication rates.
CONCLUSIONS: The overall complication rate was 6.29% in patients undergoing AF ablation. There was a significant association between operator and hospital volume on adverse outcomes. This suggests a need for future research into identifying the safety measures in AF ablations and instituting appropriate interventions to improve overall AF ablation outcomes.
PMID: 24061087 [PubMed - as supplied by publisher]