title: Frequencies, costs, and complications of catheter ablation for tachyarrhythmias in children: 2000-2009.
abstract: BACKGROUND
  Over the past two decades, catheter ablation (CA) has revolutionized the treatment of tachyarrhythmias in children by providing a relatively safe and effective alternative to open heart surgery or lifelong pharmacotherapy. This study (1) described national trends in pediatric CAs and their associated costs and complications and (2) predicted the likelihood of major complications based on patient and hospital characteristics.
  
  
  METHODS
  Inpatient data were obtained from the Kids' Inpatient Database for the years 2000, 2003, 2006, and 2009. Outpatient data were obtained from the California, Maryland, and New Jersey State Ambulatory Surgery Databases for the years 2006 and 2009. Logistic regression was used to predict the odds of major complications from CA.
  
  
  RESULTS
  There was a 20% increase (4,134-4,967) in the number of pediatric CAs performed from 2006 to 2009 that was concomitant with a decrease in the percentage of those procedures being performed as inpatient procedures (2,254-1,846). In 2009, a complication rate of 4.81% was estimated. For inpatient CAs, higher risk patients (with congenital heart disease, congestive heart failure, or heart transplant), ablations for ventricular tachycardias, and low-CA-volume hospitals were associated with increased risk of complications. In 2009, the mean cost of a hospitalization involving CA, but no cardiac surgery, was $17,204 (standard error = $1,015).
  
  
  CONCLUSIONS
  CA has increasingly been used over the past decade for pediatric patients with a multitude of tachycardia mechanisms. There continues to be a small risk of major complications, especially for higher risk children and in hospitals with more limited experience with the procedure.
authors.affiliation: James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Vibha C A
authors.initials: VC
authors.lastname: Desai
authors.forename: Christina M L
authors.initials: CM
authors.lastname: Kelton
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Czosek
authors.forename: Pamela C
authors.initials: PC
authors.lastname: Heaton
mesh_terms: D000293:Adolescent; D017115:Catheter Ablation / Q000191:economics* / Q000401:mortality / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000191:economics* / Q000401:mortality*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000191:economics* / Q000453:epidemiology; D012307:Risk Factors; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000191:economics / Q000401:mortality / Q000601:surgery*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Kids’ Inpatient Database; atrioventricular block; burden of illness; catheter ablation; supraventricular tachycardia; ventricular tachycardia