title: Complications of catheter ablation of ventricular tachycardia: a single-center experience.
abstract: BACKGROUND
  Catheter ablation has become an established treatment modality for a broad spectrum of ventricular tachycardias (VTs). We analyzed incidence and predictors of major complications of VT ablation procedures in a high-volume expert center.
  
  
  RESULTS
  We evaluated 548 consecutive patients who underwent 722 ablation procedures, 473 (65.5%) for structural heart disease VT in the period 2006 to 2012. There were 45 (6.2%) major complications observed in 44 patients. Access site vascular complications were the most frequent (3.6%). Three patients (0.4%) had cardiac tamponade/hemopericardium, and 5 patients (0.7%) had a thromboembolic event. No procedural deaths occurred. Procedures for structural heart disease VT versus idiopathic VT had a significantly higher complication rate (8.0% versus 2.8%; P=0.006). Similarly, patients with electrical storm (10.1% versus 5.3%; P=0.04) and nonelective procedures (8.4% versus 3.5%; P=0.007) were at higher risk of complications. On multivariate analysis, age >70 years (P=0.01), serum creatinine >115 μmol/L (P=0.0003), and individual operator (P=0.0001) were the only independent predictors of complications. Overall 30-day mortality in the structural heart disease VT group reached 5.0% (patients) and 3.6% (procedures). Death was associated with early recurrence of VT/ventricular fibrillation (P=0.003) and ablation for electrical storm (P=0.02).
  
  
  CONCLUSIONS
  Complication rates for VT ablation are significantly lower in idiopathic VT or in elective procedures. Independent predictors of complications include age, renal insufficiency, and individual operator. Postprocedural mortality is predicted by early recurrence of VT/ventricular fibrillation and ablation for electrical storm.
authors: From the Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. pepi@medicon.cz.
authors: Petr
authors: P
authors: Peichl
authors: From the Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: Dan
authors: D
authors: Wichterle
authors: From the Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: Ludek
authors: L
authors: Pavlu
authors: From the Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: Robert
authors: R
authors: Cihak
authors: From the Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: Bashar
authors: B
authors: Aldhoon
authors: From the Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: Josef
authors: J
authors: Kautzner
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects* / Q000401:mortality; D016009:Chi-Square Distribution; D002983:Clinical Competence; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D061847:Hospitals, High-Volume; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D051437:Renal Insufficiency / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: catheter ablation; ventricular tachycardia