title: Safety of ventricular tachycardia ablation in clinical practice: findings from 9699 hospital discharge records.
abstract: BACKGROUND
  Outcomes of ventricular tachycardia (VT) ablation have been described in clinical trials and single-center studies. We assessed the safety of VT ablation in clinical practice.
  
  
  RESULTS
  Using administrative hospitalization data between 1994 and 2011, we identified hospitalizations with primary diagnosis of VT (International Classification of Diseases-9 Clinical Modification code: 427.1) and cardiac ablation (International Classification of Diseases-9 Clinical Modification code: 37.34). We quantified in-hospital adverse events (AEs), including death, stroke, intracerebral hemorrhage, pericardial complications, hematoma or hemorrhage, blood transfusion, or cardiogenic shock. Secondary outcomes included major AEs (stroke, tamponade, or death) and death. Multivariable mixed effects models identified patient and hospital characteristics associated with AEs. Of 9699 hospitalizations with VT ablations (age, 56.5 ± 17.6; 60.1% men), AEs were reported in 825 (8.5%), major AEs in 295 (3.0%), and death in 110 (1.1%). Heart failure had the strongest association with death (odds ratio, 5.52; 95% confidence interval, 2.97-10.3) and major AE (odds ratio, 2.99; 95% confidence interval, 2.15-4.16). Anemia (odds ratio, 4.84; 95% confidence interval, 3.79-6.19) and unscheduled admission (odds ratio, 1.64; 95% confidence interval, 1.37-1.97) were associated with AEs. During the study period, incidence of AEs increased from 9.2% to 12.8% as did the burden of AE risk factors (0.034 patient/y; P < 0.001). Hospital volume > 25 cases/y was associated with fewer AEs compared with lower volume centers (6.4% versus 8.8%; P = 0.008).
  
  
  CONCLUSIONS
  VT ablation-associated AE rates in clinical practice are similar to those reported in the literature. Over time rates have increased as have the number of AE risk factors per patient. Ablations done electively and at hospitals with higher procedural volume are associated with lower incidence of AEs.
authors: From the University of Colorado, Aurora (D.F.K., W.H.S., W.S.T., M.M.Z., R.G.A., P.D.V., D.P.K.); VA Palo Alto Health Care System, Stanford University, CA (M.P.T.); University of Colorado Health, Fort Collins (R.R.H.); and Eastern Colorado VA Medical Center, Denver (P.D.V.). David.Katz@UCDenver.edu.
authors: David F
authors: DF
authors: Katz
authors: From the University of Colorado, Aurora (D.F.K., W.H.S., W.S.T., M.M.Z., R.G.A., P.D.V., D.P.K.); VA Palo Alto Health Care System, Stanford University, CA (M.P.T.); University of Colorado Health, Fort Collins (R.R.H.); and Eastern Colorado VA Medical Center, Denver (P.D.V.).
authors: Mintu P
authors: MP
authors: Turakhia
authors: From the University of Colorado, Aurora (D.F.K., W.H.S., W.S.T., M.M.Z., R.G.A., P.D.V., D.P.K.); VA Palo Alto Health Care System, Stanford University, CA (M.P.T.); University of Colorado Health, Fort Collins (R.R.H.); and Eastern Colorado VA Medical Center, Denver (P.D.V.).
authors: William H
authors: WH
authors: Sauer
authors: From the University of Colorado, Aurora (D.F.K., W.H.S., W.S.T., M.M.Z., R.G.A., P.D.V., D.P.K.); VA Palo Alto Health Care System, Stanford University, CA (M.P.T.); University of Colorado Health, Fort Collins (R.R.H.); and Eastern Colorado VA Medical Center, Denver (P.D.V.).
authors: Wendy S
authors: WS
authors: Tzou
authors: From the University of Colorado, Aurora (D.F.K., W.H.S., W.S.T., M.M.Z., R.G.A., P.D.V., D.P.K.); VA Palo Alto Health Care System, Stanford University, CA (M.P.T.); University of Colorado Health, Fort Collins (R.R.H.); and Eastern Colorado VA Medical Center, Denver (P.D.V.).
authors: Russell R
authors: RR
authors: Heath
authors: From the University of Colorado, Aurora (D.F.K., W.H.S., W.S.T., M.M.Z., R.G.A., P.D.V., D.P.K.); VA Palo Alto Health Care System, Stanford University, CA (M.P.T.); University of Colorado Health, Fort Collins (R.R.H.); and Eastern Colorado VA Medical Center, Denver (P.D.V.).
authors: Matthew M
authors: MM
authors: Zipse
authors: From the University of Colorado, Aurora (D.F.K., W.H.S., W.S.T., M.M.Z., R.G.A., P.D.V., D.P.K.); VA Palo Alto Health Care System, Stanford University, CA (M.P.T.); University of Colorado Health, Fort Collins (R.R.H.); and Eastern Colorado VA Medical Center, Denver (P.D.V.).
authors: Ryan G
authors: RG
authors: Aleong
authors: From the University of Colorado, Aurora (D.F.K., W.H.S., W.S.T., M.M.Z., R.G.A., P.D.V., D.P.K.); VA Palo Alto Health Care System, Stanford University, CA (M.P.T.); University of Colorado Health, Fort Collins (R.R.H.); and Eastern Colorado VA Medical Center, Denver (P.D.V.).
authors: Paul D
authors: PD
authors: Varosy
authors: From the University of Colorado, Aurora (D.F.K., W.H.S., W.S.T., M.M.Z., R.G.A., P.D.V., D.P.K.); VA Palo Alto Health Care System, Stanford University, CA (M.P.T.); University of Colorado Health, Fort Collins (R.R.H.); and Eastern Colorado VA Medical Center, Denver (P.D.V.).
authors: David P
authors: DP
authors: Kao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D016208:Databases, Factual; D017558:Elective Surgical Procedures; D005260:Female; D061847:Hospitals, High-Volume; D061846:Hospitals, Low-Volume; D006801:Humans; D015994:Incidence; D038801:International Classification of Diseases; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010351:Patient Discharge; D061214:Patient Safety; D011183:Postoperative Complications / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: catheter ablation; complication; tachycardia