Comparison of Complications of Catheter Ablation for Ventricular Arrhythmias in Adults With Versus Without Structural Heart Disease

Gbolahan O. Ogunbayo, Richard Charnigo, Yousef Darrat, Jignesh Shah, Ripa Patel, John Suffredini, William Wilson, Kevin Parrott, Nathan Kusterer, Luigi Di Biase, Andrea Natale, Gustavo Morales, Claude S. Elayi

Research output: Contribution to journalArticle

Abstract

Catheter ablation (CA) is an effective treatment for ventricular arrhythmias (VA), with a potential for complications. The presence of structural heart disease (SHD) is associated with a higher complication rate although there is no data comparing CA of VA between patients with SHD and those without. We aimed to compare trends, morbidity, and mortality associated with real world practice of CA for VA (ventricular tachycardia and premature ventricular contraction) based on the presence of SHD. Using weighted sampling in the National Inpatient Sample database, we collected and compared characteristics and outcomes of patients with or without SHD that underwent CA of VA. Among 34,907 patients that underwent CA for VA (1999–2013), 18,014 (51.6%) had SHD. Major and all complications occurred among 1,135/18,014 (6.3%) and 2139/18,014 (11.9%) patients with SHD respectively compared with 355/16,893 (2.1%) and 739/16,893 (4.4%) for patients without SHD, p < 0.001 for both comparisons. Furthermore, 452/18,014 (2.51%) with SHD died versus 20/16,893 (0.12%) without SHD, p < 0.001. Heart failure was associated with an odds ratio (OR) of 3.09 for major complications (95%CI: 1.53–6.27, p = 0.002) for patients with SHD while coronary artery disease OR for major complications was 2.47 (95%CI: 1.44–4.23, p = 0.001) for patients without SHD. There was a significant increase in major complications over the 15-year study period in patients with SHD, p < 0.001. In conclusion, the presence of SHD during CA for VA increased the complication rate of major and any complications by approximately threefold for both and the hospital mortality by >20-fold compared with patients without SHD.

Original languageEnglish (US)
JournalAmerican Journal of Cardiology
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

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Catheter Ablation
Cardiac Arrhythmias
Heart Diseases
Ventricular Premature Complexes
Ventricular Tachycardia
Inpatients
Databases
Morbidity
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of Complications of Catheter Ablation for Ventricular Arrhythmias in Adults With Versus Without Structural Heart Disease. / Ogunbayo, Gbolahan O.; Charnigo, Richard; Darrat, Yousef; Shah, Jignesh; Patel, Ripa; Suffredini, John; Wilson, William; Parrott, Kevin; Kusterer, Nathan; Di Biase, Luigi; Natale, Andrea; Morales, Gustavo; Elayi, Claude S.

In: American Journal of Cardiology, 01.01.2018.

Research output: Contribution to journalArticle

Ogunbayo, GO, Charnigo, R, Darrat, Y, Shah, J, Patel, R, Suffredini, J, Wilson, W, Parrott, K, Kusterer, N, Di Biase, L, Natale, A, Morales, G & Elayi, CS 2018, 'Comparison of Complications of Catheter Ablation for Ventricular Arrhythmias in Adults With Versus Without Structural Heart Disease', American Journal of Cardiology. https://doi.org/10.1016/j.amjcard.2018.07.001
Ogunbayo, Gbolahan O. ; Charnigo, Richard ; Darrat, Yousef ; Shah, Jignesh ; Patel, Ripa ; Suffredini, John ; Wilson, William ; Parrott, Kevin ; Kusterer, Nathan ; Di Biase, Luigi ; Natale, Andrea ; Morales, Gustavo ; Elayi, Claude S. / Comparison of Complications of Catheter Ablation for Ventricular Arrhythmias in Adults With Versus Without Structural Heart Disease. In: American Journal of Cardiology. 2018.
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abstract = "Catheter ablation (CA) is an effective treatment for ventricular arrhythmias (VA), with a potential for complications. The presence of structural heart disease (SHD) is associated with a higher complication rate although there is no data comparing CA of VA between patients with SHD and those without. We aimed to compare trends, morbidity, and mortality associated with real world practice of CA for VA (ventricular tachycardia and premature ventricular contraction) based on the presence of SHD. Using weighted sampling in the National Inpatient Sample database, we collected and compared characteristics and outcomes of patients with or without SHD that underwent CA of VA. Among 34,907 patients that underwent CA for VA (1999–2013), 18,014 (51.6{\%}) had SHD. Major and all complications occurred among 1,135/18,014 (6.3{\%}) and 2139/18,014 (11.9{\%}) patients with SHD respectively compared with 355/16,893 (2.1{\%}) and 739/16,893 (4.4{\%}) for patients without SHD, p < 0.001 for both comparisons. Furthermore, 452/18,014 (2.51{\%}) with SHD died versus 20/16,893 (0.12{\%}) without SHD, p < 0.001. Heart failure was associated with an odds ratio (OR) of 3.09 for major complications (95{\%}CI: 1.53–6.27, p = 0.002) for patients with SHD while coronary artery disease OR for major complications was 2.47 (95{\%}CI: 1.44–4.23, p = 0.001) for patients without SHD. There was a significant increase in major complications over the 15-year study period in patients with SHD, p < 0.001. In conclusion, the presence of SHD during CA for VA increased the complication rate of major and any complications by approximately threefold for both and the hospital mortality by >20-fold compared with patients without SHD.",
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T1 - Comparison of Complications of Catheter Ablation for Ventricular Arrhythmias in Adults With Versus Without Structural Heart Disease

AU - Ogunbayo, Gbolahan O.

AU - Charnigo, Richard

AU - Darrat, Yousef

AU - Shah, Jignesh

AU - Patel, Ripa

AU - Suffredini, John

AU - Wilson, William

AU - Parrott, Kevin

AU - Kusterer, Nathan

AU - Di Biase, Luigi

AU - Natale, Andrea

AU - Morales, Gustavo

AU - Elayi, Claude S.

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N2 - Catheter ablation (CA) is an effective treatment for ventricular arrhythmias (VA), with a potential for complications. The presence of structural heart disease (SHD) is associated with a higher complication rate although there is no data comparing CA of VA between patients with SHD and those without. We aimed to compare trends, morbidity, and mortality associated with real world practice of CA for VA (ventricular tachycardia and premature ventricular contraction) based on the presence of SHD. Using weighted sampling in the National Inpatient Sample database, we collected and compared characteristics and outcomes of patients with or without SHD that underwent CA of VA. Among 34,907 patients that underwent CA for VA (1999–2013), 18,014 (51.6%) had SHD. Major and all complications occurred among 1,135/18,014 (6.3%) and 2139/18,014 (11.9%) patients with SHD respectively compared with 355/16,893 (2.1%) and 739/16,893 (4.4%) for patients without SHD, p < 0.001 for both comparisons. Furthermore, 452/18,014 (2.51%) with SHD died versus 20/16,893 (0.12%) without SHD, p < 0.001. Heart failure was associated with an odds ratio (OR) of 3.09 for major complications (95%CI: 1.53–6.27, p = 0.002) for patients with SHD while coronary artery disease OR for major complications was 2.47 (95%CI: 1.44–4.23, p = 0.001) for patients without SHD. There was a significant increase in major complications over the 15-year study period in patients with SHD, p < 0.001. In conclusion, the presence of SHD during CA for VA increased the complication rate of major and any complications by approximately threefold for both and the hospital mortality by >20-fold compared with patients without SHD.

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