Abstract 18117: Trends in the Utilization and Outcomes of Medicare Beneficiaries Undergoing Catheter Ablation for Ventricular Tachycardia
Background: Sustained ventricular tachycardia (VT) is a significant cause of sudden death, progressive ventricular dysfunction, and heart failure hospitalizations. Radiofrequency catheter ablation is used to control incessant VT and prevent or reduce the frequency of VT episodes. However, data regarding mortality and complication rates with VT ablation are limited.
Objective: To measure the incidence of procedural complications, repeat ablations, hospitalization for heart failure and ventricular tachycardia, and short and long term mortality in patients undergoing VT ablation.
Methods: We conducted a population-based, retrospective cohort study of all fee-for-service Medicare beneficiaries who underwent catheter ablation for VT between 2000 and 2012. The main outcome measures were major complications within 30 days and 1-year rates of death, repeat ablation and heart failure and VT hospitalization.
Results: There were 21,073 patients that received a VT ablation during the study period (mean age 70 years; 77% were men; 90% were white). The ablation frequency increased from 647 in 2000 to 2,760 in 2012. The 30-day incidence of pericardial complications was 2.3%, vascular complications 6.8%, stroke or transient ischemic attack 1.5%, need for mechanical circulatory support 2.3%, and death 4.2%. The 1-year incidence per 1,000 person-years for repeat ablation was 81, death 176, and hospitalization for heart failure and VT 156 and 272, respectively (Figure).
Conclusions: Utilization of catheter ablation for VT has increased over the past 12 years. Major complications after VT ablation are relatively infrequent, but not trivial. These findings should inform discussion of potential procedural complications and long term prognosis and may have considerable implications when discussing treatment options for patients with VT.
Author Disclosures: O. Yousuf: None. R. Zusterzeel: None. W. Sanders: None. C. Dekmezian: None. H. Silverman: None. T. MaCurdy: None. S. Nazarian: None. R. Berger: None. D. Marinac-Dabic: None. D. Caños: None. D. Strauss: None.
- © 2014 by American Heart Association, Inc.