Abstract 16360: Elective Ablation for Ventricular Tachycardia: Patient Characteristics and Predictors of Poor Outcome
Introduction: The aim of our study was to describe patient characteristics and predictors of mortality in patients undergoing elective ablation for ventricular tachycardia in a national database.
Methods: Using the National Inpatient Sample database from 1998 - 2013, we identified patients with a primary diagnosis of Ventricular Tachycardia (VT) and primary procedure of ablation. We described baseline characteristics and compared the outcomes in the elective ablation to the non-elective cohort. We computed composite pre-admission and in-hospital morbidity variables and performed logistic regression analysis with mortality as the primary outcome.
Results: We identified 9311 patients who had a primary diagnosis of VT and also underwent a VT ablation as their primary procedure. Mean age was 55.8±17.3 and 64.3% were male. Of these, 42.6% (n=3,965) were elective procedures. Younger age (0-64) and female gender were independently associated with an elective VT ablation (χ2= 109, p<.001) and (χ2= 31. P<.001) respectively. Patients that had elective ablation had fewer comorbidities (old MI, chronic ischemic heart disease, CHF, hypertension, diabetes and renal failure) (χ2= 152; P<.001). Patients with private insurance were more likely to have elective VT ablation (χ2= 131. P<.001). Compared to the non-elective cohort, the elective ablation group had less morbidity (cardiogenic shock, respiratory failure, acute renal failure, acute stroke and cardiac arrest) (χ2= 124, P<0.001). They also required less transfusion, mechanical ventilation, dialysis and balloon pump support (χ2= 145, P<0.001). The elective VT ablation group also had lower mortality (0.6% vs. 1.8% p=<.001), shorter length of stay (2.62±3.37 vs. 5.62±5.40; p<.001), lower number of procedures (3±2 vs. 4±2; p<.001) and lower total charges ($61,878 vs. $78,946; p<0.001). The odds for mortality was significantly higher in patients above 65 years [OR=4.31, CI=1.68-11.02].
Conclusions: Patients that underwent elective VT ablation were younger, healthier and were more likely to have private insurance. They also had less post-procedural morbidity and mortality than the non-elective cohort. Patients above 65 years of age were more likely to die following an elective VT ablation.
Author Disclosures: G.O. Ogunbayo: None. O. Olorunfemi: None. A. Elbadawi: None. D. Saheed: None.
- © 2016 by American Heart Association, Inc.