Short-term outcomes associated with inpatient ventricular tachycardia catheter ablation

Pacing Clin Electrophysiol. 2020 May;43(5):444-455. doi: 10.1111/pace.13905. Epub 2020 May 2.

Abstract

Background: Utilization of catheter ablation of ventricular tachycardia (VT) has steadily increased in recent years. Exploring short-term outcomes is vital in health care planning and resource allocation.

Methods: The Nationwide Readmissions Database from 2010 to 2014 was queried using the ICD-9 codes for VT (427.1) and catheter ablation (37.34) to identify study population. Incidence, causes of 30-day readmission, in-hospital complications as well as predictors of 30-day readmissions, complications, and cost of care were analyzed.

Results: Among 11 725 patients who survived to discharge after index admission for VT ablation, 1911 (16.3%) were readmitted within 30 days. Paroxysmal VT was the most common cause of 30-day readmission (39.51%). Dyslipidemia, chronic kidney disease (CKD), previous CABG, congestive heart failure (CHF), chronic pulmonary disease, and anemia predicted increased risk of 30-day readmissions. The overall in-hospital complication rate was 8.2% with vascular and cardiac complications being the most common. Co-existing CKD and CHF and the need for mechanical circulatory support (MCS) predicted higher complication rates. Similarly increasing age, CKD, CHF, anemia, in-hospital use of MCS or left heart catheterization, teaching hospital, and disposition to nursing facilities predicted higher cost.

Conclusion: Approximately one in six patients was readmitted after VT ablation, with paroxysmal VT being the most common cause of the readmission. A complication rate of 8.2% was noted. We also identified a predictive model for increased risk of readmission, complication, and factors influencing the cost of care that can be utilized to improve the outcomes related to VT ablation.

Keywords: NRD database; catheter ablation; readmission; ventricular tachycardia.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Catheter Ablation / economics
  • Catheter Ablation / methods*
  • Databases, Factual
  • Female
  • Humans
  • Inpatients
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data*
  • Postoperative Complications / epidemiology*
  • Tachycardia, Ventricular / surgery*