Catheter ablation of postinfarction ventricular tachycardia: Ten-year trends in utilization, in-hospital complications, and in-hospital mortality in the United States

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

Research output: Contribution to journalArticle

64 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)2056-2063
Number of pages8
JournalHeart Rhythm
Volume11
Issue number11
DOIs
StatePublished - Nov 2014
Externally publishedYes

Keywords

  • Catheter ablation
  • Outcomes
  • Registry
  • Trends
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Palaniswamy, C., Kolte, D., Harikrishnan, P., Khera, S., Aronow, W. S., Mujib, M., Mellana, W. M., Eugenio, P., Lessner, S., Ferrick, A., Fonarow, G. C., Ahmed, A., Cooper, H. A., Frishman, W. H., 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