NIS Registry: 0.6% In-Hospital Mortality for Catheter Ablation of Cardiac Arrhythmias

April 07, 2014

MILWAUKEE, WI — The in-hospital mortality rate from catheter ablations performed for cardiac arrhythmias over the course of a decade is 0.6%, according to an analysis of the Nationwide Inpatients Sample (NIS) registry[1].

The complication rate, the most common being the need for a permanent pacemaker, was 15.2%, a figure the researchers say likely represents the "upper bound," given that they were unable to determine whether the procedure itself caused the adverse event.

Dr Michael Curley (Medical College of Wisconsin, Milwaukee) and colleagues performed the analysis, which is published online March 31, 2014 in the Journal of the American Medical Association: Internal Medicine. Between 1998 and 2009, there were 115 955 catheter ablations performed for various cardiac rhythm disorders, including supraventricular arrhythmias like atrial flutter and atrial fibrillation and other ventricular arrhythmias. More than half of the procedures were elective, and the mean age of patients was 60 years.

Regarding adverse outcomes, there were 80 emergent cardiac procedures (0.1%), 255 pericardiocenteses (0.2%), 2304 blood transfusions (2.0%), and 14 989 implantations of a permanent pacemaker (12.9%).

With mortality, there was no difference in the rate based on the year the procedure was done. As for the 0.6% mortality rate, "this likely overestimates the mortality of ablation because this includes all deaths during the index hospitalization, regardless of the association with the ablation," say the researchers. The mortality rate was comparable to the 2.2% overall mortality rate for admissions during the same period, they add.

The NIS registry includes 20% of all discharges from US hospitals.

In 2013, Dr Abhishek Deshmukh (University of Arkansas, Little Rock) and colleagues performed a large analysis of atrial-fibrillation patients who underwent catheter ablation and reported a complication rate of 6.29%. Data from a 2012 analysis of a European registry of 1300 atrial-fibrillation patients who underwent catheter ablation showed an in-hospital mortality rate of 0.07% and an in-hospital complication rate of 7.7%.

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