Patient characteristics, procedure details including catheter devices, and complications of catheter ablation for ventricular tachycardia: a nationwide observational study

Abstract

Background: Nationwide data are insufficient with respect to the characteristics of patients undergoing ventricular tachycardia (VT) ablation, complications of VT ablation, and procedure details including catheter devices used during VT ablation. The present study was performed to describe the patient characteristics, procedure details including catheter devices, and in-hospital complications of catheter ablation for VT using a national inpatient database. Methods:We used the Diagnosis Procedure Combination database, a national Japanese inpatient database, to identify patients who underwent VT ablation from July 2010 to March 2017. We examined patients' age, gender, baseline diseases, comorbid conditions, admission status, catheter devices and drugs used, and in-hospital complications of VT ablation. Results:We identified 10 641 patients (median age, 61 years) who underwent VT ablation. The most frequently observed background heart disease among patients with structural heart disease was ischemic cardiomyopathy. An irrigated ablation catheter was used in 73% of patients, a force-sensing ablation catheter was used in 22%, and intracardiac echocardiography was used in 25%. The frequency of using these procedures continuously increased over time. Overall, the prevalence of in-hospital complications was 3.5% (cardiac tamponade, 0.8%; stroke, 0.6%; critical bleeding, 1.9%; mechanical circulatory support, 0.9%; and in-hospital death, 0.8%). Conclusions: The results of this study show the clinical features of VT ablation in a real-world clinical setting. The use of irrigated catheters, force-sensing catheters, and intracardiac echocardiography increased over time. The prevalence of in-hospital complications was 3.5%. K E Y W O R D S catheter ablation, Diagnosis Procedure Combination database, nationwide observational study, ventricular tachycardia | 465 KITAMURA eT Al.

Prophylactic mechanical circulatory support for protected ventricular tachycardia ablation: A meta‐analysis of the literature

“…Catheter ablation is an established guideline‐supported 2,3 therapy for VT treatment, especially in patients with structural heart disease 26,27 or patients suffering from life‐threatening arrhythmia 9 . Although several different ablation strategies are available, 28 a considerable proportion of patients develop periprocedural AHD, which may lead to prolonged decompensation, refractory cardiogenic shock, cardiac arrest, and death 19,29‐31 . Moreover, AHD results in reduced procedural success, as it prevents prolonged activation and comprehensive entrainment mapping or makes multiple cardioversions necessary for recurrent VTs during substrate mapping.…”

Sex and racial disparities in catheter ablation

“… 53 Similar proportions among patients with structural normal hearts were reported in other retrospective registries in the United States (48% female) and Japan (42% female). 54 , 55 No sex-related differences in outcome were reported.…”