Abstract 21103: Annual Trends Outcomes and Disparities of Hemodynamic Support Utilization for Ventricular Tachycardia Ablation in Congestive Heart Failure Population in United States

Abstract

Introduction: There is limited real world data evaluating the role of hemodynamic support (HS) during ventricular tachycardia (VT) ablation in congestive heart failure (CHF) patients. Hypothesis: We sought to investigate the annual trends, gender and racial disparities in utilization of HS and hospital mortality after VT ablation with HS in CHF population. Methods: Using the U.S. National Inpatient Sample (NIS) database from 2010-2014, we identified all discharge records with CHF (CCS code 108) and a primary diagnosis of VT (ICD-9-CM diagnosis code 427.1) undergoing catheter ablation (ICD-9-CM procedure code 37.34). Records with diagnosis of supraventricular arrhythmia and cardiogenic shock were excluded. Patients receiving HS on the day of VT ablation were identified using respective ICD-9-CM procedure codes, percutaneous ventricular assist device [pVAD] 37.68, and extracorporeal membrane oxygenation [ECMO] 39.65. Statistical analyses were performed using R (Vienna, Austria). To account for the single cluster stratified random sampling design of NIS, R survey package was used to obtain national estimates. Proportions were compared with Chi-Square test, and p trend computed using Mann-Kendall test. Results: Of 6,837 VT ablations, 353 (5.1%) were performed with HS. Use of HS consistently increased over the study period (0.37% vs. 3.64%; p trend <0.001). Age adjusted hospital mortality was higher in patients receiving HS (4.2% vs. 2.0%; p < 0.001). Men and minority races (blacks, hispanics) had higher use of HS. Among patients who received HS, women and minority races had higher age adjusted hospital mortality (Figure) . Conclusion: Utilization of HS for VT ablation is increasing in this nationally representative population. Unadjusted rates show disparities in the use of HS, with lower use in women and caucasians. Hospital mortality was higher in patients receiving HS, with disproportionately high rates in women and minorities.