TY - JOUR
T1 - In-hospital complications associated with catheter ablation of atrial fibrillation in the United States between 2000 and 2010
T2 - Analysis of 93 801 procedures
AU - Deshmukh, Abhishek
AU - Patel, Nileshkumar J.
AU - Pant, Sadip
AU - Shah, Neeraj
AU - Chothani, Ankit
AU - Mehta, Kathan
AU - Grover, Peeyush
AU - Singh, Vikas
AU - Vallurupalli, Srikanth
AU - Savani, Ghanshyambhai T.
AU - Badheka, Apurva
AU - Tuliani, Tushar
AU - Dabhadkar, Kaustubh
AU - Dibu, George
AU - Reddy, Y. Madhu
AU - Sewani, Asif
AU - Kowalski, Marcin
AU - Mitrani, Raul
AU - Paydak, Hakan
AU - Viles-Gonzalez, Juan F.
PY - 2013/11/5
Y1 - 2013/11/5
N2 - 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.
AB - 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.
KW - atrial fibrillation'catheter ablation'complications
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U2 - 10.1161/CIRCULATIONAHA.113.003862
DO - 10.1161/CIRCULATIONAHA.113.003862
M3 - Article
C2 - 24061087
AN - SCOPUS:84887183606
SN - 0009-7322
VL - 128
SP - 2104
EP - 2112
JO - Circulation
JF - Circulation
IS - 19
ER -