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Safety of Ventricular Tachycardia Ablation in Clinical Practice: Findings from 9,699 Hospital Discharge Records.
Circ Arrhythm Electrophysiol. 2015 Feb 15;
Authors: Katz DF, Turakhia MP, Sauer WH, Tzou WS, Heath RR, Zipse MM, Aleong RG, Varosy PD, Kao DP
Abstract
BACKGROUND: -Outcomes of ventricular tachycardia (VT) ablation have been described in clinical trials and single-center studies. We assessed the safety of VT ablation in clinical practice.
METHODS AND RESULTS: -Using administrative hospitalization data between 1994-2011 we identified hospitalizations with primary diagnosis of VT (ICD-9 CM code: 427.1) and cardiac ablation (ICD-9 CM code: 37.34). We quantified in-hospital adverse events (AEs) including death, stroke, intracerebral hemorrhage, pericardial complications, hematoma or hemorrhage, blood transfusion or cardiogenic shock. Secondary outcomes included major adverse events (MAE) (stroke, tamponade or death) and death. Multivariable mixed effects models identified patient and hospital characteristics associated with AEs. Of 9699 hospitalizations with VT ablations (age 56.5±17.6; 60.1% male), AEs were reported in 825 (8.5%), MAEs in 295 (3.0%) and death in 110 (1.1%). Heart failure had the strongest association with death (OR 5.52, 95% CI 2.97-10.3) and MAE (OR 2.99, 95% CI 2.15-4.16). Anemia (OR 4.84, 95% CI 3.79-6.19) and unscheduled admission (OR 1.64, 95% CI 1.37-1.97) were associated with AEs. Over the study period, incidence of AEs increased from 9.2% to 12.8% as did the burden of AE risk factors (0.034 patient/year, p<0.001). Hospital volume>25 cases/year was associated with fewer AEs compared with lower volume centers (6.4% vs. 8.8%, p=0.008).
CONCLUSIONS: -VT ablation-associated AE rates in clinical practice are similar to those reported in the literature. Over time rates have increased as have the number of AE risk factors per patient. Ablations done electively and at hospitals with higher procedural volume are associated with lower incidence of AEs.
PMID: 25688143 [PubMed - as supplied by publisher]