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

Safety of Ventricular Tachycardia Ablation in Clinical Practice

“…24 In comparison with a recent report using data from the National Inpatient Survey examining patients undergoing ablation for postinfarct VT, we found higher AE and in-hospital death rates (17.6% versus 11.2% and 3.3% versus 1.6%) (24), but MAE and in-hospital death rates were similar to those seen in clinical trials of ablation for recurrent VT with predominantly ischemic heart disease. 1,4,24 Overall, the odds of death among HF patients with or without CAD were significantly elevated when compared with odds of death in patients without structural heart disease but statistically similar to one another. In patients without structural heart disease, MAE rates were lower than that reported from Brigham and Women's Hospital and in a Spanish registry (1.4% versus 3.4% versus 3.4%), although the occurrence of in-hospital death was higher (0.3% versus 0% versus 0%).…”

“…Relationships between annual VT ablation volumes of <10, 10 to 25, and >25 were quantified on the basis of recently published data, suggesting a relationship between these VT ablation volumes and in-hospital complications. 1 Data about proceduralist volume were not available.…”

“…1,2 Previous studies suggest that patients without structural heart disease experience greater procedural success and fewer periprocedural complications, [3][4][5][6][7][8][9][10][11][12][13][14] but little more is known about the factors that predispose patients to complications. Although a recent observational study assessed the incidence of complications in patients with postinfarct VT ablation, 1 the vast majority of literature addressing complications of VT ablation come from randomized trials or high-volume single-center retrospective studies.…”

“…1,2 Previous studies suggest that patients without structural heart disease experience greater procedural success and fewer periprocedural complications, [3][4][5][6][7][8][9][10][11][12][13][14] but little more is known about the factors that predispose patients to complications. Although a recent observational study assessed the incidence of complications in patients with postinfarct VT ablation, 1 the vast majority of literature addressing complications of VT ablation come from randomized trials or high-volume single-center retrospective studies. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] With their small sample sizes and relatively low absolute numbers of adverse events (AEs), these publications preclude conclusions about clinical and institutional characteristics associated with periprocedural AEs or changes in event rates over time.…”

“…22 We included all hospital encountering with an endovascular cardiac ablation (International Classification of Diseases-9 [ICD-9] Clinical Modification [CM] code: 37.34) and a primary discharge diagnosis of VT (ICD-9 CM code: 427.1). 1,23 All other hospital records were excluded. All ICD-9 CM codes used in this analysis are found in the table in the Data Supplement.…”