In-hospital complications associated with catheter ablation of atrial fibrillation in the United States between 2000 and 2010: analysis of 93 801 procedures.
Publication/Presentation Date
11-5-2013
Abstract
BACKGROUND: Atrial fibrillation ablation has made tremendous progress with respect to innovation, efficacy, and safety. However, limited data exist regarding the burden and trends in adverse outcomes arising from this procedure. The aim of our study was to examine the frequency of adverse events attributable to atrial fibrillation (AF) ablation and the influence of operator and hospital volume on outcomes.
METHODS AND RESULTS: With the use of the Nationwide Inpatient Sample, we identified AF patients treated with catheter ablation. We investigated common complications including cardiac perforation and tamponade, pneumothorax, stroke, transient ischemic attack, vascular access complications (hemorrhage/hematoma, vascular complications requiring surgical repair, and accidental arterial puncture), and in-hospital death described with AF ablation, and we defined these complications by using validated International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. An estimated 93,801 AF ablations were performed from 2000 to 2010. The overall frequency of complications was 6.29% with combined cardiac complications (2.54%) being the most frequent. Cardiac complications were 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 (nonsignificant) 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 and 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.
Volume
128
Issue
19
First Page
2104
Last Page
2112
ISSN
1524-4539
Published In/Presented At
Deshmukh, A., Patel, N. J., Pant, S., Shah, N., Chothani, A., Mehta, K., Grover, P., Singh, V., Vallurupalli, S., Savani, G. T., Badheka, A., Tuliani, T., Dabhadkar, K., Dibu, G., Reddy, Y. M., Sewani, A., Kowalski, M., Mitrani, R., Paydak, H., & Viles-Gonzalez, J. F. (2013). In-hospital complications associated with catheter ablation of atrial fibrillation in the United States between 2000 and 2010: analysis of 93 801 procedures. Circulation, 128(19), 2104–2112. https://doi.org/10.1161/CIRCULATIONAHA.113.003862
Disciplines
Medicine and Health Sciences
PubMedID
24061087
Department(s)
Fellows and Residents
Document Type
Article