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Publications

Journal Article Epublish

PubMed: 41892722 DOI: 10.3390/jcdd13030134

Nationwide Multicentric Analysis Regarding In-Hospital Complications After Catheter Ablation of Cardiac Arrhythmias.

J Cardiovasc Dev Dis 13(3)

Authors: Florian Doldi, Christian Meyer, Johannes Brachmann, Fabienne Kreimer, Thorsten Lewalter, Roland Tilz, Malte Kuniss, Ibrahim Akin, Philipp Sommer, Thomas Riemer, Jochen Senges, Lars Eckardt

Affiliations

  • Department for Cardiology II: Electrophysiology, University Hospital Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, Germany.
  • Departement of Cardiology, Angiology, Intensive Care Medicine, EVK Düsseldorf, cNEP, cardiac Neuro- and Electrophysiology Research Consortium, 40217 Düsseldorf, Germany.
  • Department of Cardiology, Angiology and Pulmonology, Klinikum Coburg, 96450 Coburg, Germany.
  • Department of Cardiology and Intensive Unit Care, Hospital Munich South, Peter Osypka Heart Center, 81379 Munich, Germany.
  • Department of Cardiac Electrophysiology, University Hospital Schleswig-Holstein-Campus Lübeck, 23562 Lübeck, Germany.
  • Kerckhoff Heart Center, 61231 Bad Nauheim, Germany.
  • Department of Cardiology, First Department of Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany.
  • Department of Electrophysiology, Heart and Diabetes Center NRW, Ruhr University Bochum, 32545 Bad Oeynhausen, Germany.
  • Stiftung Institut für Herzinfarktforschung (IHF), 67063 Ludwigshafen, Germany.

Abstract

OBJECTIVE AND BACKGROUND

With the increasing use of catheter ablation for tachyarrhythmias, continuous evaluation of in-hospital complications is essential. This study aimed at analyzing complications associated with catheter ablation for atrial fibrillation (AF), atrial flutter (AFL), and ventricular tachycardia (VT) using nationwide administrative data.

METHODS

We conducted a retrospective multicentric data analysis from large German ablation centers between 2018 and 2023. Patients were identified using ICD and OPS codes for AF, AFL, and VT regarding predefined in-hospital complications: mortality, stroke, pericardial tamponade, pulmonary embolism, and vascular complications requiring intervention.

RESULTS

Among 19,258 ablation procedures from 11 centers, AF was most common (n = 12,241), followed by AFL (n = 5582) and VT (n = 1435). Major complications occurred in 2.2% (n = 433) of cases. VT ablations had the highest complication rate (9.8%), followed by AF (1.6%) and AFL (1.7%). Pericardial tamponade occurred in 0.9% patients, most commonly in VT ablations (4.0%). Vascular complications requiring intervention were reported in 1.1%, while stroke (0.3%) and pulmonary embolism (0.05%) were rare. In-hospital mortality was highest in VT patients (2.4%), compared to AF (0.08%) and AFL (0.13%). Higher AFL mortality as compared to AF was associated with older age and more comorbidities. Upon exploratory analysis, no statistical association between hospital volume and complication rates could be seen.

CONCLUSIONS

In this multicenter analysis, catheter ablation was associated with a low overall complication rate. VT ablations carried the highest risk, highlighting the impact of structural heart disease and comorbidities.

MeSH

Tachycardia, Ventricular, Comorbidity, Mortality, Atrial Flutter, Embolism, Stroke, Arrhythmias, Cardiac, Hospital Mortality, Atrial Fibrillation, Pulmonary Embolism, Catheter Ablation, Catheters