title: Catheter ablation of postinfarction ventricular tachycardia: ten-year trends in utilization, in-hospital complications, and in-hospital mortality in the United States.
abstract: BACKGROUND
  There is a paucity of data regarding the complications and in-hospital mortality after catheter ablation for ventricular tachycardia (VT) in patients with ischemic heart disease.
  
  
  OBJECTIVE
  The purpose of this study was to determine the temporal trends in utilization, in-hospital mortality, and complications of catheter ablation of postinfarction VT in the United States.
  
  
  METHODS
  We used the 2002-2011 Nationwide Inpatient Sample (NIS) database to identify all patients ≥18 years of age with a primary diagnosis of VT (International Classification of Diseases, Ninth Edition, Clinical Modification [ICD-9-CM] code 427.1) and who also had a secondary diagnosis of prior history of myocardial infarction (ICD-9-CM 412). Patients with supraventricular arrhythmias were excluded. Patients who underwent catheter ablation were identified using ICD-9-CM procedure code 37.34. Temporal trends in catheter ablation, in-hospital complications, and in-hospital mortality were analyzed.
  
  
  RESULTS
  Of 81,539 patients with postinfarct VT, 4653 (5.7%) underwent catheter ablation. Utilization of catheter ablation increased significantly from 2.8% in 2002 to 10.8% in 2011 (Ptrend < .001). The overall rate of any in-hospital complication was 11.2% (523/4653), with vascular complications in 6.9%, cardiac in 4.3%, and neurologic in 0.5%. In-hospital mortality was 1.6% (75/4653). From 2002 to 2011, there was no significant change in the overall complication rates (8.4% to 10.2%, Ptrend = .101; adjusted odds ratio [per year] 1.02, 95% confidence interval 0.98-1.06) or in-hospital mortality (1.3% to 1.8%, Ptrend = .266; adjusted odds ratio [per year] 1.03, 95% confidence interval 0.92-1.15).
  
  
  CONCLUSIONS
  The utilization rate of catheter ablation as therapy for postinfarct VT has steadily increased over the past decade. However, procedural complication rates and in-hospital mortality have not changed significantly during this period.
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, New York.
authors.forename: Chandrasekar
authors.initials: C
authors.lastname: Palaniswamy
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, New York.
authors.forename: Dhaval
authors.initials: D
authors.lastname: Kolte
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, New York.
authors.forename: Prakash
authors.initials: P
authors.lastname: Harikrishnan
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, New York.
authors.forename: Sahil
authors.initials: S
authors.lastname: Khera
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, New York.
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, New York.
authors.forename: Marjan
authors.initials: M
authors.lastname: Mujib
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, New York.
authors.forename: William Michael
authors.initials: WM
authors.lastname: Mellana
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, New York.
authors.forename: Paul
authors.initials: P
authors.lastname: Eugenio
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, New York.
authors.forename: Seth
authors.initials: S
authors.lastname: Lessner
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, New York.
authors.forename: Aileen
authors.initials: A
authors.lastname: Ferrick
authors.affiliation: David Geffen School of Medicine, University of California at Los Angeles (UCLA), Los Angeles, California.
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.affiliation: University of Alabama at Birmingham and VA Medical Center, Birmingham, Alabama.
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmed
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, New York.
authors.forename: Howard A
authors.initials: HA
authors.lastname: Cooper
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, New York.
authors.forename: William H
authors.initials: WH
authors.lastname: Frishman
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, New York.
authors.forename: Julio A
authors.initials: JA
authors.lastname: Panza
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, New York. Electronic address: iwais@wcmc.com.
authors.forename: Sei
authors.initials: S
authors.lastname: Iwai
mesh_terms: D000368:Aged; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D011183:Postoperative Complications / Q000401:mortality; D012042:Registries; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000401:mortality* / Q000601:surgery*; D014481:United States; D014600:Utilization Review
keywords: Catheter ablation; Outcomes; Registry; Trends; Ventricular tachycardia