Arrhythmias & electrophysiology

Major in-hospital complications after catheter ablation of cardiac arrhythmias: individual case analysis of 43 031 procedures

EuropacePublished Retrospective multicentre cohort study

Authors' conclusion

Major adverse events are low and comparable after catheter ablation for AFL and AF (∼1.0%), whereas they are five times higher for VT ablations.

Study context

Population
Catheter ablations for atrial fibrillation (AF), atrial flutter and ventricular tachycardia (VT) in four German tertiary centres, 2005–2020
Participants
43,031 ablations
Exposure
AF vs atrial flutter (AFL) vs VT ablation
  • AFn = 30,361
  • AFLn = 9,364
  • VTn = 3,306
Outcome
Major in-hospital complications (femoral vascular complications, iatrogenic tamponade, stroke, in-hospital death)
Follow-up
In-hospital
Methodological details4 German tertiary centres, individual case adjudication
  • 4 German tertiary centres
  • Individual case adjudication

Main finding

As reported in the abstract

Major peri-procedural complications
Overall major complications
594 (1.4%)

Observational data: associations, not effects.

Further findings

In-hospital mortality, ablation-related (adjudicated) vs coded

Adjudicated

Coded

Overall complication rate over time · 2005 vs 2020

2005
0.76%
2020
1.81%
Increase
P = 0.004

Ablations per year · 2005 vs 2020

All ablations 2005 vs 2020
1569 vs 3317
AF 2005 vs 2020
817 vs 2404
VT 2005 vs 2020
120 vs 301
AFL
554 vs 612

Specific complications (all patients) · in-hospital

Cardiac tamponade (all ablation-related)
0.7%
Stroke (all ablation-related)
0.2%
Femoral vascular complications requiring surgery
0.4%

Original publication

Major in-hospital complications after catheter ablation of cardiac arrhythmias: individual case analysis of 43 031 procedures. Europace. Published 15 December 2023. doi:10.1093/europace/euad361

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