Catheter Ablation for Supraventricular Tachycardia: Trends for Utilization and In-Hospital Complications between 2000-2013

Guy Rozen Cardiovascular Institute, Baruch Padeh Medical Center, Tiberias, Israel Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, Massachusetts, USA Seyed Mohammadreza Hosseini Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, Massachusetts, USA Jeena Vaid Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, Massachusetts, USA Yitschak Biton Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, Massachusetts, USA M. Ihsan Kaadan Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, Massachusetts, USA E. Kevin Heist Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, Massachusetts, USA Moussa Mansour Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, Massachusetts, USA Jeremy Ruskin Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, Massachusetts, USA

Background: Catheter ablation has become the mainstay therapy for supraventricular tachycardia (SVT) in the last three decades. This study assessed the evolving trends for SVT ablation procedures nationwide.

Objectives: To investigate the trends in utilization and periprocedural complications in patients undergoing catheter ablation for SVT in US from 2000–2013, using the National Inpatient Sample (NIS) database.

Methods: Using the NIS database for 2000-2013, we identified patients 18 years of age or older who underwent inpatient catheter ablation with a primary diagnosis of any form of SVT. Baseline demographic and clinical characteristics, as well as in-hospital complications were analyzed.

Results: An estimated total of 159,895 inpatient ablations were performed in US for SVT during the study period. The median patient age was 54 (IQR: 40–68) years, 58.7% were female. There was a significant trend for aging (Ptrend=0.001), as well as an increase in the Deyo-Charlson Comorbidity Index (Ptrend<0.001) of the patients throughout the study period. In parallel, there was a significant increase in the rate of major complications from 2.9% in 2000-2001 to 5.05% in 2012-2013 (Ptrend=0.009 for 2000-2013).

Conclusion: There was a substantial increase in periprocedural complication rates in patients undergoing in-hospital SVT ablation in the US from 2000-2013. This is likely related to progressive increases in age and comorbidity indices among patients undergoing inpatient ablation procedures and a shift to outpatient procedures for younger, healthier patients with SVT.

Guy Rozen

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