Catheter ablation of ventricular tachycardia in nonischemic cardiomyopathy: A propensity score-matched analysis of in-hospital outcomes in the United States

David F. Briceño, Tanush Gupta, Jorge E. Romero, Dhaval Kolte, Sahil Khera, Pedro A. Villablanca, An Tran, Sanghamitra Mohanty, Chintan Trivedi, Prasant Mohanty, Carola Gianni, Soo G. Kim, Mario J. Garcia, Gregg C. Fonarow, Deepak L. Bhatt, Andrea Natale, Luigi Di Biase

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Introduction: Monomorphic ventricular tachycardia (VT) is an important cause of morbidity and mortality. Use and outcome data of catheter ablation for VT in nonischemic cardiomyopathy (NICM) are limited. Methods and results: We obtained data from the 2003-2014 National Inpatient Sample databases. We used propensity score matching to compare patients undergoing catheter ablation versus medical therapy of VT related to NICM, and described the temporal trends in utilization and in-hospital outcomes of catheter ablation of VT in patients with NICM in the United States. From 2003 to 2014, of 133,529 patients hospitalized with the principal diagnosis of VT in NICM, 14,651 (11.0%) underwent catheter ablation. In this period, there was an increasing trend in utilization of catheter ablation (9.3% in 2003-2004 to 12.1% in 2003-2014, adjusted OR [per year], 1.12; 95% CI, 1.08-1.16; Ptrend < 0.001). After propensity score matching, in-hospital mortality occurred in 172 of 14,318 (1.2%) patients in the catheter ablation group, compared with 297 of 14,156 (2.1%) of patients undergoing medical therapy (47% lower; 43% relative difference [adjusted OR, 0.53; 95% CI, 0.43-0.66]). Conclusions: In patients with NICM, catheter ablation of VT is associated with lower in-hospital mortality compared with those managed medically. The utilization rates of CA for VT related to NICM have increased in the past decade. Adequately powered randomized trials will be necessary to confirm these findings.

Original languageEnglish (US)
JournalJournal of Cardiovascular Electrophysiology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Propensity Score
Catheter Ablation
Ventricular Tachycardia
Cardiomyopathies
Hospital Mortality
Inpatients
Databases
Morbidity
Mortality
Therapeutics

Keywords

  • Catheter ablation
  • Heart failure
  • In-hospital outcomes
  • Mortality
  • National Inpatient Sample databases
  • Nonischemic cardiomyopathy
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Catheter ablation of ventricular tachycardia in nonischemic cardiomyopathy : A propensity score-matched analysis of in-hospital outcomes in the United States. / Briceño, David F.; Gupta, Tanush; Romero, Jorge E.; Kolte, Dhaval; Khera, Sahil; Villablanca, Pedro A.; Tran, An; Mohanty, Sanghamitra; Trivedi, Chintan; Mohanty, Prasant; Gianni, Carola; Kim, Soo G.; Garcia, Mario J.; Fonarow, Gregg C.; Bhatt, Deepak L.; Natale, Andrea; Di Biase, Luigi.

In: Journal of Cardiovascular Electrophysiology, 01.01.2018.

Research output: Contribution to journalArticle

Briceño, David F. ; Gupta, Tanush ; Romero, Jorge E. ; Kolte, Dhaval ; Khera, Sahil ; Villablanca, Pedro A. ; Tran, An ; Mohanty, Sanghamitra ; Trivedi, Chintan ; Mohanty, Prasant ; Gianni, Carola ; Kim, Soo G. ; Garcia, Mario J. ; Fonarow, Gregg C. ; Bhatt, Deepak L. ; Natale, Andrea ; Di Biase, Luigi. / Catheter ablation of ventricular tachycardia in nonischemic cardiomyopathy : A propensity score-matched analysis of in-hospital outcomes in the United States. In: Journal of Cardiovascular Electrophysiology. 2018.
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abstract = "Introduction: Monomorphic ventricular tachycardia (VT) is an important cause of morbidity and mortality. Use and outcome data of catheter ablation for VT in nonischemic cardiomyopathy (NICM) are limited. Methods and results: We obtained data from the 2003-2014 National Inpatient Sample databases. We used propensity score matching to compare patients undergoing catheter ablation versus medical therapy of VT related to NICM, and described the temporal trends in utilization and in-hospital outcomes of catheter ablation of VT in patients with NICM in the United States. From 2003 to 2014, of 133,529 patients hospitalized with the principal diagnosis of VT in NICM, 14,651 (11.0{\%}) underwent catheter ablation. In this period, there was an increasing trend in utilization of catheter ablation (9.3{\%} in 2003-2004 to 12.1{\%} in 2003-2014, adjusted OR [per year], 1.12; 95{\%} CI, 1.08-1.16; Ptrend < 0.001). After propensity score matching, in-hospital mortality occurred in 172 of 14,318 (1.2{\%}) patients in the catheter ablation group, compared with 297 of 14,156 (2.1{\%}) of patients undergoing medical therapy (47{\%} lower; 43{\%} relative difference [adjusted OR, 0.53; 95{\%} CI, 0.43-0.66]). Conclusions: In patients with NICM, catheter ablation of VT is associated with lower in-hospital mortality compared with those managed medically. The utilization rates of CA for VT related to NICM have increased in the past decade. Adequately powered randomized trials will be necessary to confirm these findings.",
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T1 - Catheter ablation of ventricular tachycardia in nonischemic cardiomyopathy

T2 - A propensity score-matched analysis of in-hospital outcomes in the United States

AU - Briceño, David F.

AU - Gupta, Tanush

AU - Romero, Jorge E.

AU - Kolte, Dhaval

AU - Khera, Sahil

AU - Villablanca, Pedro A.

AU - Tran, An

AU - Mohanty, Sanghamitra

AU - Trivedi, Chintan

AU - Mohanty, Prasant

AU - Gianni, Carola

AU - Kim, Soo G.

AU - Garcia, Mario J.

AU - Fonarow, Gregg C.

AU - Bhatt, Deepak L.

AU - Natale, Andrea

AU - Di Biase, Luigi

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction: Monomorphic ventricular tachycardia (VT) is an important cause of morbidity and mortality. Use and outcome data of catheter ablation for VT in nonischemic cardiomyopathy (NICM) are limited. Methods and results: We obtained data from the 2003-2014 National Inpatient Sample databases. We used propensity score matching to compare patients undergoing catheter ablation versus medical therapy of VT related to NICM, and described the temporal trends in utilization and in-hospital outcomes of catheter ablation of VT in patients with NICM in the United States. From 2003 to 2014, of 133,529 patients hospitalized with the principal diagnosis of VT in NICM, 14,651 (11.0%) underwent catheter ablation. In this period, there was an increasing trend in utilization of catheter ablation (9.3% in 2003-2004 to 12.1% in 2003-2014, adjusted OR [per year], 1.12; 95% CI, 1.08-1.16; Ptrend < 0.001). After propensity score matching, in-hospital mortality occurred in 172 of 14,318 (1.2%) patients in the catheter ablation group, compared with 297 of 14,156 (2.1%) of patients undergoing medical therapy (47% lower; 43% relative difference [adjusted OR, 0.53; 95% CI, 0.43-0.66]). Conclusions: In patients with NICM, catheter ablation of VT is associated with lower in-hospital mortality compared with those managed medically. The utilization rates of CA for VT related to NICM have increased in the past decade. Adequately powered randomized trials will be necessary to confirm these findings.

AB - Introduction: Monomorphic ventricular tachycardia (VT) is an important cause of morbidity and mortality. Use and outcome data of catheter ablation for VT in nonischemic cardiomyopathy (NICM) are limited. Methods and results: We obtained data from the 2003-2014 National Inpatient Sample databases. We used propensity score matching to compare patients undergoing catheter ablation versus medical therapy of VT related to NICM, and described the temporal trends in utilization and in-hospital outcomes of catheter ablation of VT in patients with NICM in the United States. From 2003 to 2014, of 133,529 patients hospitalized with the principal diagnosis of VT in NICM, 14,651 (11.0%) underwent catheter ablation. In this period, there was an increasing trend in utilization of catheter ablation (9.3% in 2003-2004 to 12.1% in 2003-2014, adjusted OR [per year], 1.12; 95% CI, 1.08-1.16; Ptrend < 0.001). After propensity score matching, in-hospital mortality occurred in 172 of 14,318 (1.2%) patients in the catheter ablation group, compared with 297 of 14,156 (2.1%) of patients undergoing medical therapy (47% lower; 43% relative difference [adjusted OR, 0.53; 95% CI, 0.43-0.66]). Conclusions: In patients with NICM, catheter ablation of VT is associated with lower in-hospital mortality compared with those managed medically. The utilization rates of CA for VT related to NICM have increased in the past decade. Adequately powered randomized trials will be necessary to confirm these findings.

KW - Catheter ablation

KW - Heart failure

KW - In-hospital outcomes

KW - Mortality

KW - National Inpatient Sample databases

KW - Nonischemic cardiomyopathy

KW - Ventricular tachycardia

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