title: Incidence and predictors of major complications from contemporary catheter ablation to treat cardiac arrhythmias.
abstract: BACKGROUND
  Updated understanding of the risks of catheter ablation is important because techniques have evolved for procedures treating non-life-threatening as well as potentially lethal arrhythmias.
  
  
  OBJECTIVE
  This prospective study sought to assess the incidence and predictors of major complications from contemporary catheter ablation procedures at a high-volume center.
  
  
  METHODS
  Over a 2-year period, 1,676 consecutive ablation procedures were prospectively evaluated for major complications throughout 30 days postprocedure. Predictors of major complications were determined in a multivariate analysis adjusted for demographics, clinical variables, ablation type, and procedural factors.
  
  
  RESULTS
  Rates of major complications differed between procedure types, ranging from 0.8% for supraventricular tachycardia, 3.4% for idiopathic ventricular tachycardia (VT), 5.2% for atrial fibrillation (AF), and 6.0% for VT associated with structural heart disease (SHD). Ablation type (ablation for AF [odds ratio (OR) 5.53, 95% confidence interval (CI) 1.81 to 16.83], for VT with SHD [OR 8.61, 95% CI 2.37 to 31.31], or for idiopathic VT [OR 5.93, 95% CI 1.40 to 25.05] all referenced to supraventricular tachycardia ablation), and serum creatinine level >1.5 mg/dl (OR 2.48, 95% CI 1.07 to 5.76) were associated with increased adjusted risk of major complications, whereas age, gender, body mass index, international normalized ratio level, hypertension, coronary artery disease, diabetes, and prior cerebrovascular accident were not associated with increased risk.
  
  
  CONCLUSIONS
  In a large cohort of contemporary catheter ablation, major complication rates ranged between 0.8% and 6.0% depending on the ablation procedure performed. Aside from ablation type, renal insufficiency was the only independent predictor of a major complication.
authors.affiliation: Cardiac Arrhythmia Service, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Marius
authors.initials: M
authors.lastname: Bohnen
authors.forename: William G
authors.initials: WG
authors.lastname: Stevenson
authors.forename: Usha B
authors.initials: UB
authors.lastname: Tedrow
authors.forename: Gregory F
authors.initials: GF
authors.lastname: Michaud
authors.forename: Roy M
authors.initials: RM
authors.lastname: John
authors.forename: Laurence M
authors.initials: LM
authors.lastname: Epstein
authors.forename: Christine M
authors.initials: CM
authors.lastname: Albert
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Koplan
mesh_terms: D000367:Age Factors; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000503:physiopathology / Q000601:surgery*; D015992:Body Mass Index; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology