Catheter Ablation of Postinfarction Ventricular Tachycardia: Ten-Year Trends in Utilization, In-Hospital Complications, and In-Hospital Mortality in the United States

Authors

Chandrasekar Palaniswamy, New York Medical CollegeFollow
Dhaval Kolte
Prakash Harikrishnan, New York Medical CollegeFollow
Sahil Khera, New York Medical CollegeFollow
Wilbert S. Aronow, New York Medical CollegeFollow
Marjan Mujib
William Michael Mellana
Paul Eugenio, New York Medical CollegeFollow
Seth Lessner, New York Medical CollegeFollow
Aileen Ferrick, New York Medical CollegeFollow
Gregg C. Fonarow
Ali Ahmed
Howard A. Cooper
William Frishman, New York Medical CollegeFollow
Julio A. Panza, New York Medical CollegeFollow
Sei Iwai, New York Medical CollegeFollow

Author Type(s)

Faculty

DOI

10.1016/j.hrthm.2014.07.012

Journal Title

Heart Rhythm

First Page

2056

Last Page

2063

Document Type

Article

Publication Date

11-1-2014

Department

Medicine

Keywords

Aged, Catheter Ablation, Female, Hospital Mortality, Humans, Middle Aged, Myocardial Infarction, Postoperative Complications, Registries, Risk Factors, Tachycardia, Ventricular, United States, Utilization Review

Disciplines

Medicine and Health Sciences

Abstract

BACKGROUND: There is a paucity of data regarding the complications and in-hospital mortality after catheter ablation for ventricular tachycardia (VT) in patients with ischemic heart disease.

OBJECTIVE: The purpose of this study was to determine the temporal trends in utilization, in-hospital mortality, and complications of catheter ablation of postinfarction VT in the United States.

METHODS: We used the 2002-2011 Nationwide Inpatient Sample (NIS) database to identify all patients ≥18 years of age with a primary diagnosis of VT (International Classification of Diseases, Ninth Edition, Clinical Modification [ICD-9-CM] code 427.1) and who also had a secondary diagnosis of prior history of myocardial infarction (ICD-9-CM 412). Patients with supraventricular arrhythmias were excluded. Patients who underwent catheter ablation were identified using ICD-9-CM procedure code 37.34. Temporal trends in catheter ablation, in-hospital complications, and in-hospital mortality were analyzed.

RESULTS: Of 81,539 patients with postinfarct VT, 4653 (5.7%) underwent catheter ablation. Utilization of catheter ablation increased significantly from 2.8% in 2002 to 10.8% in 2011 (Ptrend < .001). The overall rate of any in-hospital complication was 11.2% (523/4653), with vascular complications in 6.9%, cardiac in 4.3%, and neurologic in 0.5%. In-hospital mortality was 1.6% (75/4653). From 2002 to 2011, there was no significant change in the overall complication rates (8.4% to 10.2%, Ptrend = .101; adjusted odds ratio [per year] 1.02, 95% confidence interval 0.98-1.06) or in-hospital mortality (1.3% to 1.8%, Ptrend = .266; adjusted odds ratio [per year] 1.03, 95% confidence interval 0.92-1.15).

CONCLUSION: The utilization rate of catheter ablation as therapy for postinfarct VT has steadily increased over the past decade. However, procedural complication rates and in-hospital mortality have not changed significantly during this period.

Recommended Citation

Palaniswamy, C., Kolte, D., Harikrishnan, P., Khera, S., Aronow, W. S., Mujib, M., Mellana, W., Eugenio, P., Lessner, S., Ferrick, A., Fonarow, G. C., Ahmed, A., Cooper, H. A., Frishman, W., Panza, J. A., & Iwai, S. (2014). Catheter Ablation of Postinfarction Ventricular Tachycardia: Ten-Year Trends in Utilization, In-Hospital Complications, and In-Hospital Mortality in the United States. Heart Rhythm, 11 (11), 2056-2063. https://doi.org/10.1016/j.hrthm.2014.07.012