In-hospital complications associated with catheter ablation of atrial fibrillation in the United States between 2000 and 2010

Analysis of 93 801 procedures

Abhishek Deshmukh, Nileshkumar J. Patel, Sadip Pant, Neeraj Shah, Ankit Chothani, Kathan Mehta, Peeyush Grover, Vikas Singh, Srikanth Vallurupalli, Ghanshyambhai T. Savani, Apurva Badheka, Tushar Tuliani, Kaustubh Dabhadkar, George Dibu, Y. Madhu Reddy, Asif A. Sewani, Marcin Kowalski, Raul Mitrani, Hakan Paydak, Juan F. Viles-Gonzalez

Research output: Contribution to journalArticle

290 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)2104-2112
Number of pages9
JournalCirculation
Volume128
Issue number19
DOIs
StatePublished - Nov 5 2013
Externally publishedYes

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Catheter Ablation
Atrial Fibrillation
Blood Vessels
Safety
Cardiac Tamponade
Transient Ischemic Attack
International Classification of Diseases
Pneumothorax
Hospital Mortality
Punctures
Hematoma
Inpatients
Stroke
Hemorrhage

Keywords

  • atrial fibrillation'catheter ablation'complications

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

In-hospital complications associated with catheter ablation of atrial fibrillation in the United States between 2000 and 2010 : Analysis of 93 801 procedures. / Deshmukh, Abhishek; Patel, Nileshkumar J.; Pant, Sadip; Shah, Neeraj; Chothani, Ankit; Mehta, Kathan; Grover, Peeyush; Singh, Vikas; Vallurupalli, Srikanth; Savani, Ghanshyambhai T.; Badheka, Apurva; Tuliani, Tushar; Dabhadkar, Kaustubh; Dibu, George; Reddy, Y. Madhu; Sewani, Asif A.; Kowalski, Marcin; Mitrani, Raul; Paydak, Hakan; Viles-Gonzalez, Juan F.

In: Circulation, Vol. 128, No. 19, 05.11.2013, p. 2104-2112.

Research output: Contribution to journalArticle

Deshmukh, A, Patel, NJ, Pant, S, Shah, N, Chothani, A, Mehta, K, Grover, P, Singh, V, Vallurupalli, S, Savani, GT, Badheka, A, Tuliani, T, Dabhadkar, K, Dibu, G, Reddy, YM, Sewani, AA, Kowalski, M, Mitrani, R, Paydak, H & Viles-Gonzalez, JF 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, vol. 128, no. 19, pp. 2104-2112. https://doi.org/10.1161/CIRCULATIONAHA.113.003862
Deshmukh, Abhishek ; Patel, Nileshkumar J. ; Pant, Sadip ; Shah, Neeraj ; Chothani, Ankit ; Mehta, Kathan ; Grover, Peeyush ; Singh, Vikas ; Vallurupalli, Srikanth ; Savani, Ghanshyambhai T. ; Badheka, Apurva ; Tuliani, Tushar ; Dabhadkar, Kaustubh ; Dibu, George ; Reddy, Y. Madhu ; Sewani, Asif A. ; Kowalski, Marcin ; Mitrani, Raul ; Paydak, Hakan ; Viles-Gonzalez, Juan F. / In-hospital complications associated with catheter ablation of atrial fibrillation in the United States between 2000 and 2010 : Analysis of 93 801 procedures. In: Circulation. 2013 ; Vol. 128, No. 19. pp. 2104-2112.
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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.",
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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 A.

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.

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